161669 Improving the Use of Hospice Services among Minority Elders

Monday, November 5, 2007

Kyusuk Chung, PhD , Health Administration, Governors State University, University Park, IL
Minority elders underutilize hospice services: 26% of non-Hispanic white Medicare decedents in 2003 had been under hospice care, compared to 21% of Hispanic decedents, 18% of African Americans, and 14% of Asians. This racial difference is more noticeable when the elders reside and die in nursing homes or assisted living facilities than when they die in their private residences. Previous studies have also found that minorities are less likely than white elders to be referred to hospice by physicians. To increase hospice utilization among minority residents in nursing homes and assisted living facilities, we implement a simple communication intervention that a previous study found to be efficient. We plan to conduct a structured interview of 120 residents and/or their surrogate decision makers to identify residents whose goals for care, treatment preferences, and palliative care needs make them appropriate for hospice care. These residents' physicians will be notified and be asked to authorize a hospice informational visit. The outcome measures include (1) hospice enrollment within 30 days of the intervention and (2) families' ratings of the quality of care for residents who die during the 6-month follow-up period. The referral rates among minority elderly will be compared before and after the intervention.

Learning Objectives:
1) Recognize characteristics of minority patients that are associated with underutilization of hospice services 2) Evaluate/apply an intervention that can improve a communication about end-of-life care preferences between physicians and their patients. 2)

Keywords: End-of-Life Care, Health Disparities

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.