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Hispanic Hospice Utilization: Integrative Review and Meta-analysis.
Journal of Health Care for the Poor and Underserved
|May 28, 2019
Summary
Hispanics are underrepresented in hospice care, particularly for heart failure, stroke, and cancer. Palliative care enrollment is similar, but overall hospice use is lower, raising health equity concerns.
Area of Science:
- Health Services Research
- Health Equity
- End-of-Life Care
Background:
- Hospice provides patient-centered end-of-life care.
- Hispanics are underrepresented in hospice utilization compared to their U.S. population share.
- Disparities in hospice access and utilization among Hispanic populations require investigation.
Purpose of the Study:
- To systematically review and meta-analyze literature on Hispanic underrepresentation in hospice care.
- To compare hospice enrollment rates between Hispanic and non-Hispanic White (NHW) populations across different conditions.
- To explore factors influencing hospice utilization and discuss implications for health equity.
Main Methods:
- Systematic literature review and meta-analysis.
- Comparison of hospice enrollment rates using relative ratios (RR) and odds ratios (OR).
- Analysis of data across conditions including palliative care, heart failure, stroke, and cancer.
Main Results:
- Hispanic hospice enrollment is comparable to NHWs in palliative care (RR 1.02).
- Hispanics show significantly lower hospice use for heart failure (OR 0.49) and stroke (OR 0.77).
- Meta-analysis indicated lower relative hospice use in Hispanics for cancer (RR 0.96).
Conclusions:
- Significant disparities exist in hospice utilization for specific conditions, with Hispanics being less likely to use hospice than NHWs.
- Concerns regarding data validity arise due to demographic differences (age, health, insurance) between Hispanic and NHW populations.
- Hospice quality metrics may offer a more accurate representation of health equity than enrollment rates alone.
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