Racial/ethnic disparities in hospice care: a systematic review

Access to hospice is a growing public health matter given that quality care at the end of life should be provided to all individuals regardless of race, ethnicity, or socioeconomic status. Health care disparities, particularly among racial and ethnic groups, have been well documented in the scientific literature. However, little is known about the demographics of hospice users or the use of hospice services by specific racial and ethnic groups.

This paper is a systematic literature review of studies that examine rates of hospice use among minority patients versus white patients.

Comprehensive literature searches were conducted using the standard scientific search engines MEDLINE, PubMed, Psych Info, and the Cochrane Library for articles published from 1980 through January 2006.

Twelve of 13 relevant studies found differences in hospice use between minorities and whites. The majority of studies were retrospective cohort studies using administrative data. No randomized controlled studies, meta-analyses, or any formal literature review were found.

Racial variations in hospice use indicate minorities use services disproportionately less than white patients, even after researchers control for specific sociodemographic and clinical characteristics.