Ethnic Variation in Timing of Hospice Referral: Does Having No Informal Caregiver Matter?

Chung, Kyusuk; Essex, Elizabeth Lehr; Samson, Linda F.

doi:10.1089/jpm.2007.0149

Cited by 11 publications

(8 citation statements)

References 23 publications

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“…Five studies 47 –51 describe how Hispanics are affected by caregiving and provide evidence of interventions to support them. A qualitative study using interviews of 30 Latino and white cancer-bereaved hospice family caregivers demonstrated poor hospice knowledge, familial decision making, denial and secrecy (did not approve that doctor informed patient that he/she was dying), and more satisfaction with hospice service among Latinos when compared to white caregivers.…”

Section: Resultsmentioning

confidence: 99%

What Evidence is Available on End-of-life (EOL) Care and Latino Elders? A Literature Review

Cruz‐Oliver

Talamantes

Sanchez-Reilly

2013

Am J Hosp Palliat Care

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Section: Resultsmentioning

confidence: 99%

What Evidence is Available on End-of-life (EOL) Care and Latino Elders? A Literature Review

Cruz‐Oliver

Talamantes

Sanchez-Reilly

2013

Am J Hosp Palliat Care

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“…16 Moreover, among patients with formal caregivers, minority patients had shorter length of stays in hospice prior to death or discharge compared to whites; however, there was no significant differences between patients with informal caregivers. 13 In contrast, another study showed that by 2000, the median survival for both blacks and whites was <30 days, and equal amounts (25%) of blacks and whites died within seven days of hospice admission. 17 The use of hospice services among blacks compared to whites was lower in the early 1990s, but these differences resolved by 2000.…”

Section: Introductionmentioning

confidence: 97%

Racial disparities in length of stay in hospice care by tumor stage in a large elderly cohort with non-small cell lung cancer

Hardy

Chan²,

Liu³

et al. 2011

Palliat Med

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This study examined whether there are racial disparities for length of stay in hospice for patients with non-small cell lung cancer (NSCLC).We studied 53,626 deceased patients aged ≥66 years diagnosed with American Joint Committee on Cancer stages I-IV NSCLC identified from the Surveillance, Epidemiology, and End Results-Medicare linked data who used hospice services in the last six months before death, and died between 1 January 1991 and 31 December 2005. Median time (days) and percent length of stay in hospice, and multivariate incidence rate ratios (IRRs) with 95% confidence intervals (CIs) using zero-truncated negative binomial regression described relationships. In 2000-2005, most patients (64.1%) had <30 days, including those (30.2%) with <7 days length of stay in hospice care. After adjusting for confounders, the IRR for length of stay in hospice compared to whites was 38% increased for blacks (IRR = 1.38; 95% CI: 1.01-1.89), and almost three-fold increased for Hispanics (IRR = 2.91;95% CI: 1.15-7.37) at stages I-II. However, blacks at stages III-IV had slightly decreased use of hospice services (IRR = 0.91; 95% CI: 0.85-0.97). Length of stay decreased slightly among blacks diagnosed with late stage (III-IV) NSCLC in 2000-2005.The gap in disparity for length of stay in hospice has narrowed for ethnic minorities compared to whites, while some ethnic minorities had greater length of stay at early disease stage.

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“…Additional studies revealed that most physicians cite late hospice referrals as a direct result of family reluctance to accept patient prognosis and that death was near. 14,15 Research by Teno et al 16 revealed that hospice referrals were appropriate; however, short hospice stays affected the quality of end-of-life care received. Transition from personal culture to organizational culture depends on the individual physician’s medical training and acculturation into the health care system.…”

Section: Resultsmentioning

confidence: 99%

Culture and End-of-Life Care

Yapp

2011

Am J Hosp Palliat Care

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Beneficence is a fundamental concept of medicine, which embodies the notion above all, do no harm. While this principle illustrates the health care professional's duty to contribute to the patient's welfare, the principle becomes convoluted when the wishes of the patient directly conflict with that of the physician. The purpose of the study was to determine the degree to which cultural beliefs influence a physician's decision to introduce the concept of hospice to terminally ill patients. This phenomenological study explored the perceptions of 14 physicians practicing medicine in Mercer County, New Jersey. Analysis of the textural data revealed the following 5 themes: (a) physician personal perspectives, (b) physician perspectives on culture, (c) perspectives on hospice care, (d) communication with patients, and (e) training and experience.

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Ethnic Variation in Timing of Hospice Referral: Does Having No Informal Caregiver Matter?

Cited by 11 publications

References 23 publications

What Evidence is Available on End-of-life (EOL) Care and Latino Elders? A Literature Review

What Evidence is Available on End-of-life (EOL) Care and Latino Elders? A Literature Review

Racial disparities in length of stay in hospice care by tumor stage in a large elderly cohort with non-small cell lung cancer

Culture and End-of-Life Care

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