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首页> 外文期刊>The Gerontologist >Racial Differences in Hospice Use and In-Hospital Death Among Medicare and Medicaid Dual-Eligible Nursing Home Residents
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Racial Differences in Hospice Use and In-Hospital Death Among Medicare and Medicaid Dual-Eligible Nursing Home Residents

机译：医疗保险和医疗补助双重合格疗养院居民在临终关怀使用和医院内死亡方面的种族差异

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Purpose: We investigated the role of race in predicting the likelihood of using hospice and dying in a hosptial among dual-eligible (Medicare and Medicaid) nursing home residents. Design and Methods: This follow-back cohort study examined factors associated with hospice use and in-hospital death among non-Hispanic Black and non-Hispanic White dual-eligible nursing home residents [N = 30,765) who died in Florida during one of three years: 2000, 2001, or 2002. We used logistic regression models to identify independent predictors of hospice use and in-hospital death. Results: After we controlled for other factors, Black residents were significantly less likely to use hospice and more likely to die in a hospital. Principal cause of death moderated the relationship between race and hospice use: Black residents were significantly less likely to use hospice than White residents among residents without cancer as principal cause of death, but there was no difference among residents with cancer as cause of death. Further analyses for each racial group revealed that the impact of cause of death in predicting hospice use was greater among Black residents than White residents. Implications: Hospice care offers many benefits, including reduced risk of in-hospital death, but Black nursing home residents are less likely to use hospice and may have different perceptions of need for hospice care compared with White residents. Future research and outreach efforts should focus on developing culturally sensitive, disease-focused end-of-life education and communication interventions that target residents, families, nursing home providers, and physicians. [PUBLICATION ABSTRACT]
机译：目的：我们调查了种族在预测有双重资格的（Medicare和Medicaid）疗养院居民中使用临终关怀和在医院死亡的可能性中的作用。设计与方法：这项追踪队列研究研究了在三分之一的佛罗里达州死亡的非西班牙裔黑人和非西班牙裔白人双重合格疗养院居民（N = 30,765）中与临终关怀使用和院内死亡相关的因素。年：2000年，2001年或2002年。我们使用逻辑回归模型来确定临终关怀使用和医院内死亡的独立预测因子。结果：在我们控制了其他因素之后，黑人居民使用临终关怀的可能性大大降低，而在医院死亡的可能性更大。主要死亡原因缓解了种族与临终关怀之间的关系：在没有癌症为主要死亡原因的居民中，黑人居民使用临终关怀的可能性明显低于白人居民，但在以癌症为死亡原因的居民之间没有差异。对每个种族的进一步分析表明，死亡原因对预测临终关怀的影响在黑人居民中比白人居民更大。启示：临终关怀提供许多好处，包括降低院内死亡风险，但是与白人居民相比，黑人疗养院居民使用临终关怀的可能性较小，对临终关怀需要的看法也有所不同。未来的研究和外展工作应着重于针对居民，家庭，疗养院提供者和医生，开发对文化敏感，以疾病为中心的报废教育和交流干预措施。 [出版物摘要]

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    《The Gerontologist》 |2008年第1期|p.32-41|共10页
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    Jung Kwak William E Haley David A Chiriboga;

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    Jung Kwak, PhD,1 William E. Haley, PhD,2 and David A. Chiriboga, PhD3This research was supported in part by a grant from the Florida Agency for Health Care Administration. The research was conducted in partial fulfillment of a doctoral dissertation at the University of South Florida, and we would like to thank Drs. Glenn Mitchell, Susan McMillan, and William Rowe for their participation on the doctoral committee. Additional assistance from Drs. Bill Kearns, Karl Kosloski, and Larry Polivka is also gratefully acknowledged.Address correspondence to Jung Kwak, PhD, Center on Age and Community/Applied Gerontology, University of Wisconsin, Milwaukee, Enderis Hall 1055, P.O. Box 786, Milwaukee, WI 53201. E-mail: kwak@uwm.edu1 Center on Age and Community/Applied Gerontology, University of Wisconsin, Milwaukee.2 School of Aging Studies, University of South Florida, Tampa.3 Department of Aging and Mental Health, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa.;

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