ArticleMedical care2011
Racial disparities in in-hospital death and hospice use among nursing home residents at the end of life.
Article in Medical care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Sociodemographic Disparities in the Use of Hospice by U.S. Nursing Home Residents: A Systematic Review.The American journal of hospice & palliative care · 2026Pooled it
- Racial/Ethnic Disparities in Nursing Home End-of-Life Care: A Systematic Review.Journal of the American Medical Directors Association · 2021Pooled it
- Hospitalizations of nursing home residents at the end of life: A systematic review.Palliative medicine · 2019Pooled it
- Black Nursing Home Residents More Likely to Watch Advance Care Planning Video.Journal of the American Geriatrics Society · 2020Trial
- Methods for studying health disparities in U.S. nursing homes: a scoping review.BMC health services research · 2025Article
- Cardiac Arrest Mortality and Disposition Patterns in United States Emergency Departments.Journal of clinical medicine · 2024Article
- Naming racism as a root cause of inequities in palliative care research: a scoping review.BMC palliative care · 2024Article
- Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis.Journal of pain and symptom management · 2024Article
- Utilization of Hospital Do-Not-Resuscitate Orders in Older Adults During COVID-19 Surges in 2020.Journal of palliative medicine · 2024Article
- Hospice Quality, Race, and Disenrollment in Hospice Enrollees With Dementia.Journal of palliative medicine · 2023Article
- Examining Regional Differences in Nursing Home Palliative Care for Black and Hispanic Residents.Journal of palliative medicine · 2022Article
- A Decade of Studying Drivers of Disparities in End-of-Life Care for Black Americans: Using the NIMHD Framework for Health Disparities Research to Map the Path Ahead.Journal of pain and symptom management · 2022Review
- Racial disparity in end-of-life hospitalizations among nursing home residents with dementia.Journal of the American Geriatrics Society · 2021Article
- Racial and Ethnic Disparities in COVID-19 Infections and Deaths Across U.S. Nursing Homes.Journal of the American Geriatrics Society · 2020Article
- Racial and Ethnic Differences in Communication and Care for Children With Advanced Cancer.Journal of pain and symptom management · 2020Article
- The Black and White of Invasive Mechanical Ventilation in Advanced Dementia.Journal of the American Geriatrics Society · 2020Article
- Conceptualizing and Counting Discretionary Utilization in the Final 100 Days of Life: A Scoping Review.Journal of pain and symptom management · 2020Article
- Health Care Utilization and End-of-Life Care Outcomes for Patients With Decompensated Cirrhosis Based on Transplant Candidacy.Journal of pain and symptom management · 2020Article
- Measuring racial segregation in health system networks using the dissimilarity index.Social science & medicine (1982) · 2019Article
- Racial Disparities in Readmission Rates among Patients Discharged to Skilled Nursing Facilities.Journal of the American Geriatrics Society · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundSignificant racial disparities have been reported regarding nursing home residents' use of hospital and hospice care at the end of life (EOL).
objectiveTo examine whether the observed racial disparities in EOL care are due to within-facility or across-facility variations. RESEARCH DESIGN AND SUBJECTS: Cross-sectional study of 49,048 long-term care residents (9.23% black and 90.77% white) in 555 New York State nursing homes who died during 2005-2007. The Minimum Data Set was linked with Medicare inpatient and hospice claims. MEASURES: In-hospital death determined by inpatient claims and hospice use determined by hospice claims. For each outcome, risk factors were added sequentially to examine their partial effects on the racial differences. Hierarchical models were fit to test whether racial disparities are due to within-facility or across-facility variations.
results40.33% of blacks and 24.07% of whites died in hospitals; 11.55% of blacks and 17.39% of whites used hospice. These differences are partially due to disparate use of feeding tubes, do-not-resuscitate and do-not-hospitalize orders. We find no racial disparities in in-hospital death [odds ratio (OR) of race=0.95; 95% confidence interval (CI), 0.87-1.04] or hospice use (OR of race=0.90, 95% CI, 0.79-1.02) within same facilities. Living in facilities with 10% more blacks increases the odds of in-hospital death by 22% (OR=1.22, 95% CI, 1.17-1.26) and decreases the odds of hospice use by 15% (OR=0.85, 95% CI, 0.78-0.94).
conclusionsDifferential use of feeding tubes, do-not-resuscitate and do-not-hospitalize orders lead to racial differences in in-hospital death and hospice use. The remaining disparities are primarily due to overall EOL care practices in predominately black facilities, not to differential hospitalization and hospice-referral patterns within facilities.
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