Featured Research

from universities, journals, and other organizations

Eligibility Criteria Contribute To Racial Disparities In Hospice Use

Date:
December 22, 2008
Source:
American Cancer Society
Summary:
A new study finds that hospice services -- care that is provided by physicians, visiting nurses, chaplains, home health aides, social workers and counselors -- have restrictions that reduce usage by many patients who are most in-need, particularly African-Americans.

A new study finds that hospice services—care that is provided by physicians, visiting nurses, chaplains, home health aides, social workers and counselors—have restrictions that reduce usage by many patients who are most in-need, particularly African Americans. The research, published in the February 1, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society, indicates that the eligibility criteria for hospice services should be reconsidered.

In order to enroll in hospice, patients must have a prognosis of six months or less if their illness runs its usual course. They must also accept the palliative nature of hospice care. African American patients are less likely than white patients to use hospice, but the reasons for this difference have remained somewhat unknown.

In the current work, investigators at the University of Pennsylvania designed a study to explore the reasons for racial disparities in hospice care among cancer patients. To define and compare preferences for cancer treatment and perceived needs for hospice services among African-American patients and white patients, Dr. David Casarett and colleagues interviewed 283 patients who were receiving cancer treatment at six oncology clinics within the University of Pennsylvania Cancer Network. Patients were asked about their perceived need for five hospice services and their preferences for continuing cancer treatment, and they were followed for six months or until death. The researchers theorized that if disparities in hospice use were the result of preference for aggressive treatment among African Americans, then their rates of hospice use could be increased by redesigning hospice eligibility criteria. Conversely, if African Americans were less likely to want hospice services, then changes to the benefit may not be necessary, but modifications to the services that are offered may be warranted.

Dr. Casarett's team found that African-American patients had stronger preferences for continuing their cancer treatments as well as greater perceived needs for hospice services. The greater perceived need for hospice services among African Americans was attributed largely to differences in self-reported finances—poorer patients wanted more services.

"These findings suggest that the hospice eligibility criteria of Medicare and other insurers requiring patients to give up cancer treatment contribute to racial disparities in hospice use," the authors wrote. "Moreover, these criteria do not select those patients with the greatest needs for hospice services," they added.

The basis for these disparities is likely related to both cultural differences and economic characteristics. The results from this study indicate that hospice access could be made fairer by using eligibility criteria that are more directly need-based. For example, the investigators suggested that eligibility might be determined by assessing needs for specific hospice services such as pain or symptom management.


Story Source:

The above story is based on materials provided by American Cancer Society. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jessica Fishman, Peter O'Dwyer, Hien L. Lu, Hope Henderson, David A. Asch, and David J. Casarett. Race, treatment preferences, and hospice enrollment: Eligibility criteria may exclude patients with the greatest needs for care. Cancer, Published Online: December 22, 2008; Print February 1, 2009 DOI: 10.1002/cncr.24046

Cite This Page:

American Cancer Society. "Eligibility Criteria Contribute To Racial Disparities In Hospice Use." ScienceDaily. ScienceDaily, 22 December 2008. <www.sciencedaily.com/releases/2008/12/081222074603.htm>.
American Cancer Society. (2008, December 22). Eligibility Criteria Contribute To Racial Disparities In Hospice Use. ScienceDaily. Retrieved October 2, 2014 from www.sciencedaily.com/releases/2008/12/081222074603.htm
American Cancer Society. "Eligibility Criteria Contribute To Racial Disparities In Hospice Use." ScienceDaily. www.sciencedaily.com/releases/2008/12/081222074603.htm (accessed October 2, 2014).

Share This



More Mind & Brain News

Thursday, October 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pregnancy Spacing Could Have Big Impact On Autism Risks

Pregnancy Spacing Could Have Big Impact On Autism Risks

Newsy (Oct. 1, 2014) A new study says children born less than one year and more than five years after a sibling can have an increased risk for autism. Video provided by Newsy
Powered by NewsLook.com
Stopping School Violence

Stopping School Violence

Ivanhoe (Oct. 1, 2014) A trauma doctor steps out of the hospital and into the classroom to teach kids how to calmly solve conflicts, avoiding a trip to the ER. Video provided by Ivanhoe
Powered by NewsLook.com
Pineal Cysts: Debilitating Pain

Pineal Cysts: Debilitating Pain

Ivanhoe (Oct. 1, 2014) A tiny cyst in the brain that can cause debilitating symptoms like chronic headaches and insomnia, and the doctor who performs the delicate surgery to remove them. Video provided by Ivanhoe
Powered by NewsLook.com
Burning Away Brain Tumors

Burning Away Brain Tumors

Ivanhoe (Oct. 1, 2014) Doctors are 'cooking' brain tumors. Hear how this new laser-heat procedure cuts down on recovery time. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins