The role of race and ethnicity in predicting length of hospice care among older adults.
BACKGROUND
The purpose of the study was to examine both direct and interactive roles of race/ethnicity with patients' characteristics (age, gender, relationship with caregiver, diagnosis, referral source, and payment type) in predicting length of hospice care.


METHODS
This study included a total of 16,323 patients 65 years of age and older (M(age)=81.4, SD=8.3) who were served by a hospice in central Florida during a four-year period, 2002-2006. Survival analyses were conducted using the Cox proportional hazards model to predict the length of hospice care and test the interaction effects of race/ethnicity.


RESULTS
The majority of subjects (83.5%) were white, 7.6% were African-American, and 8.9% were Hispanic. During the study period, 58.5% died. All patient characteristics were significantly associated with the length of hospice care (p < .05). Overall, Hispanics had the longest hospice stay (M=98.84 days), followed by African-Americans (M=90.29) and whites (M=88.20). With the exception of African-American women who were no more likely to stay longer under hospice care than African-American men, the women in this study stayed longer under hospice care than men did. Patients referred from long-term care (LTC) settings had shorter stays in hospice care compared to those referred by physicians in other settings. Additionally, African-Americans and Hispanics referred from LTC had significantly shorter hospice stays than those referred by primary physicians.


CONCLUSIONS
In this limited sample of hospice patients, length of stay was longer for minority patients than white patients.
University of South Florida, Tampa, FL, USA. nanpark@usf.edu
Nan S
NS
Park
Iraida V
IV
Carrion
Beom S
BS
Lee
Debra
D
Dobbs
Hae Jung
HJ
Shin
Marion A
MA
Becker
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005431:Florida; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D017051:Hospice Care / Q000706:statistics & numerical data*; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012017:Referral and Consultation; D016019:Survival Analysis; D044465:White People / Q000706:statistics & numerical data