KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Racial Disparities Persist In Hospice Use

Even as medical caregivers try to change practices, racial disparities in hospice care continue, according to a study in the March 8 issue of the Archives of Internal Medicine.

BusinessWeek / HealthDay News: "Blacks and Hispanics with advanced heart failure are much less likely to turn to hospice care than whites, even though blacks in particular are more likely to develop the condition, a new report finds. Heart failure, in which the heart weakens and can't beat effectively, is the second most common diagnosis for people in hospice care, which is designed for people with only months to live. Only cancer sends more people to hospice. ... About 30 percent to 50 percent of people who suffer from advanced heart failure live beyond a year. Researchers report that many people with advanced heart failure don't go to hospice, even though it is frequently recommended" (3/8).

MedPage Today: "After adjustment for sociodemographic, clinical, and geographic factors, blacks were 41% less likely to have hospice care than whites ... and Hispanics were 51% less likely ..., according to Jane Givens, MD, of Beth Israel Deaconess Medical Center in Boston, and colleagues."

"The data are consistent with previous examinations of hospice use, conducted primarily in cancer patients, the researchers noted, and the findings 'counter speculation that overall increases in the availability of hospice services in the 1990s may have erased racial and ethnic differences in hospice use.' ... Previous studies have shown that blacks are less likely than whites to complete advanced directives, and less likely to have favorable beliefs about hospice care ... [and] have also found that blacks more often report receiving inadequate information about end-of-life care and are less likely to be informed about hospice services" (Neale, 3/8).

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