title: Race/Ethnicity as a Predictor for Location of Death in Patients With Acute Neurovascular Events.
abstract: BACKGROUND
  Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community.
  
  
  METHODS
  This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services. The main outcome was location of death (palliative care inpatient unit [IPU] at the medical center or hospice services at discharge vs death on any other IPU).
  
  
  RESULTS
  A total of 655 patients admitted with acute neurovascular events from January 1, 2009, to March 1, 2015, died or were discharged with hospice services and were included in the analysis. Of those patients, 238 (36.3%) were black, 233 (35.5%) were Hispanic, and 184 (28.1%) were white. A total of 178 (24.4%) died on the palliative care unit or were discharged with hospice services, including 55 black patients (23.1%), 52 (28.3%) white patients, and 53 (22.7%) Hispanic patients. These differences were not statistically significant, even when controlling for confounders.
  
  
  CONCLUSIONS
  This study did not show a difference in site of death in our institution by race or ethnicity, which is considered an important quality end-of-life care metric.
authors.affiliation: 1 Department of Family and Social Medicine, Palliative Care Service, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Say
authors.initials: S
authors.lastname: Salomon
authors.affiliation: 1 Department of Family and Social Medicine, Palliative Care Service, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Chuang
authors.affiliation: 2 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Deepa
authors.initials: D
authors.lastname: Bhupali
authors.affiliation: 2 Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Labovitz
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000208:ethnology*; D003643:Death; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities; D006630:Hispanic or Latino; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009519:New York City; D010166:Palliative Care / Q000706:statistics & numerical data*; D011203:Poverty; D011787:Quality of Health Care; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014505:Urban Population; D044465:White People
keywords: health-care disparities; hospice care; nervous systems diseases; palliative care; stroke; terminal care