Racial disparity in hospice use in the United States in 2002.
We used complete Centers for Disease Control death certificate records and the Centers for Medicare and Medicaid Services 100% Standard Analytic File for hospice claims for 2002 to examine differences in hospice utilization between African-American and white decedents living in the United States. White decedents were more likely to use hospice in the year before their death than African-American decedents (29% vs 22%). Cause-specific hospice utilization rates among women were consistently higher than among men within a given race. African-American decedents were consistently less likely to use hospice than white decedents for almost all conditions. Hospice utilization was lower among African-American than among white decedents in 31 of 40 states. The higher the overall hospice utilization in a state, the less the positive difference between white and African-American usage rates; that is, the more accepted hospice is, as measured by 'market share', the lower the racial disparity in its use.
Connor
S R
SR
National Hospice and Palliative Care Organization, Alexandria, Virginia 22314, USA. sconnor@nhpco.org
Elwert
F
F
Spence
C
C
Christakis
N A
NA
D001741:Black or African American / Q000706:statistics & numerical data*; D002423:Cause of Death; D005260:Female; D017051:Hospice Care / Q000706:statistics & numerical data*; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D014481:United States / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data*