ArticleJournal of the American Geriatrics Society2018
Racial Disparities in Hospice Outcomes: A Race or Hospice-Level Effect?
Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review.Palliative medicine · 2022Pooled it
- Racial/Ethnic Disparities in Nursing Home End-of-Life Care: A Systematic Review.Journal of the American Medical Directors Association · 2021Pooled it
- Exploring the Acceptability and Feasibility of a Self-directed Approach to Identifying Health Priorities in a Sample of Southern Older African American Adults with Multiple Chronic Conditions.Journal of racial and ethnic health disparities · 2026Article
- Caregiver Availability and Racial Differences in End-Of-Life Care Quality: Evidence From the National Health and Aging Trends Study 2017-2024.Journal of the American Geriatrics Society · 2026Article
- Top Ten Tips Palliative Care Clinicians Should Know About Hospice Live Discharge.Journal of palliative medicine · 2025Article
- Article
- Improving Policy and Practices of Hospice Live Discharge: A Historical Exploration of the Medicare Hospice Benefit.Journal of aging & social policy · 2025Article
- Article
- Naming racism as a root cause of inequities in palliative care research: a scoping review.BMC palliative care · 2024Article
- Race and Ethnicity Are Related to Undesirable Home Health Care Outcomes in Seriously Ill Older Adults.Journal of the American Medical Directors Association · 2024Article
- Racial/ethnic disparities in inpatient palliative care utilization and hospitalization outcomes among patients with colorectal cancer.Cancer causes & control : CCC · 2024Article
- Caregiving and Obesity among Black American Adults.Social work research · 2024Article
- Hospice Quality, Race, and Disenrollment in Hospice Enrollees With Dementia.Journal of palliative medicine · 2023Article
- Role of Home Health for Community-Dwelling Older Adults Near the End of Life: A Resource Beyond Hospice?Journal of palliative medicine · 2023Article
- Comparison of the Pathway to Hospice Enrollment Between Medicare Advantage and Traditional Medicare.JAMA health forum · 2023Article
- Impact of COVID-19 Pandemic on Utilization of the Inpatient Hospice Services (General Inpatient Hospice).The American journal of hospice & palliative care · 2022Article
- Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications.Children (Basel, Switzerland) · 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
- Preparedness for Serious Illnesses: Impact of Ethnicity, Mistrust, Perceived Discrimination, and Health Communication.The American journal of hospice & palliative care · 2022Article
- Asian American Medicare Beneficiaries Disproportionately Receive Invasive Mechanical Ventilation When Hospitalized at the End-of-Life.Journal of general internal medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo determine whether there is racial variation in hospice enrollees in rates of hospitalization and hospice disenrollment and, if so, whether systematic differences in hospice provider patterns explain the variation.
designLongitudinal cohort study.
settingHospice.
participantsMedicare beneficiaries (N = 145,038) enrolled in a national random sample of hospices (N = 577) from the National Hospice Survey and followed until death (2009-10). MEASUREMENTS: We used Medicare claims data to identify hospital admissions, emergency department (ED) visits, and hospice disenrollment after hospice enrollment. We used a series of hierarchical models including hospice-level random effects to compare outcomes of blacks and whites.
resultsIn unadjusted models, black hospice enrollees were significantly more likely than white enrollees to be admitted to the hospital (14.9% vs 8.7%, odds ratio (OR) = 1.84, 95% confidence interval (CI) = 1.74-1.95), visit the ED (19.8% vs 13.5%, OR = 1.58, 95% CI = 1.50-1.66), and disenroll from hospice (18.1% vs 13.0%, OR = 1.48, 95% CI = 1.40-1.56). These results were largely unchanged after accounting for participant clinical and demographic covariates and hospice-level random effects. In adjusted models, blacks were at higher risk of hospital admission (OR = 1.75, 95% CI = 1.64-1.86), ED visits (OR = 1.61, 95% CI = 1.52-1.70), and hospice disenrollment (OR = 1.54, 95% CI = 1.45-1.63).
conclusionRacial differences in intensity of care at the end of life are not attributable to hospice-level variation in intensity of care. Differences in patterns of care between black and white hospice enrollees persist within the same hospice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.