title: Disparities in hospice utilization among American Indian Medicare beneficiaries dying of cancer.
abstract: OBJECTIVE
  We sought to compare hospice utilization for American Indian and White Medicare beneficiaries dying of cancer.
  
  
  METHODS
  We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases to analyze claims for 181,316 White and 690 American Indian patients dying of breast, cervix, colorectal, kidney, lung, pancreas, prostate cancer, or stomach cancer from 2003 to 2009.
  
  
  RESULTS
  A lower proportion of American Indians enrolled in hospice compared to White patients (54% vs 65%, respectively; P < .0001). While the proportion of White patients who used hospice services in the last 6 months of life increased from 61% in 2003 to 68% in 2009 (P < .0001), the proportion of American Indian patients using hospice care remained unchanged (P = .57) and remained below that of their White counterparts throughout the years of study.
  
  
  CONCLUSIONS
  Continued efforts should be made to improve access to culturally relevant hospice care for American Indian patients with terminal cancer.
authors.forename: B Ashleigh
authors.initials: BA
authors.lastname: Guadagnolo
authors.forename: Jinhai
authors.initials: J
authors.lastname: Huo
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Petereit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D017051:Hospice Care / Q000706:statistics & numerical data*; D006738:Hospices / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D018426:SEER Program; D019452:Terminally Ill / Q000706:statistics & numerical data*; D014481:United States; D044465:White People / Q000706:statistics & numerical data