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Black, Hispanic Patients with Dementia More Likely to Be Disenrolled from Hospice

In This Article

  • In a recent study, researchers analyzed Medicare claims and hospice data to investigate risk factors for hospice disenrollment among patients with dementia
  • At the American Geriatrics Society Annual Scientific Meeting, they reported that Black and Hispanic patients were more likely to be disenrolled
  • The research team concluded that primary care providers can improve disparities in hospice care by advocating for patients at the policy level

Black or Hispanic patients with dementia may receive lower-quality care than white patients with dementia, according to the results of a recent study. Christine Seel Ritchie, MD, MSPH, director of research in the Division of Palliative Care and Geriatric Medicine and director of the Mongan Institute Center for Aging and Serious Illness at Massachusetts General Hospital, and colleagues conducted a retrospective cohort study that looked into disparities in hospice care among patients with dementia. They presented their findings at the virtual American Geriatrics Society Annual Scientific Meeting in May 2021.

Researchers in the study analyzed Medicare claims and beneficiary data that included 889,787 beneficiaries with Alzheimer's disease or related dementia who were admitted to hospice between July 2013 and December 2016.

After one year of the initial hospice admission, researchers found that 15% of participants were disenrolled from hospice, and 9% were still patients. Patient-level factors associated with hospice disenrollment were being Black (OR=1.63; 95% CI, 1.56-1.7) or Hispanic (OR=1.61; 95% CI, 1.58- 1.64), and hospice-level factors included smaller size (OR=1.48; 95% CI, 1.46-1.51) and for-profit ownership (OR=1.26; 95% CI, 1.24-1.27).

Lauren Hunt, PhD, RN, FNP, of the University of California, San Francisco, co-author of the study, said that the results demonstrate a need for hospice care to adapt to the needs of patients from racial/ethnic minority groups. Improved care could include cultural sensitivity training or better translation services for patients who speak English as a second language, for example.

The researchers emphasized that there are opportunities for primary care providers to improve disparities in hospice care by advocating for patients with dementia, as well as their caregivers, at the policy level.

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