Exploring Discharge to Hospice for Dementia-Related Health Care Among Racial and Ethnic Minority Groups in Southern...

Background: Nearly 50,000 people aged 65 and older are living with dementia in Nevada. The number of Nevadans living with dementia is projected to increase to 65,000 or more by 2025-the third largest growth rate in the United States. Objective: We examined differences in discharge to hospice among racial and ethnic minority groups living with dementia and utilizing health care in Southern Nevada. We also explored differences by other demographic and health care-related characteristics. Methods: Data analyzed were from comprehensive health care data records from multiple health care settings in Nevada and for all causes for the years 2013-2021. Bivariate analysis and multiple logistic regression were utilized to examine differences in discharge to hospice by racial and ethnic minority groups accounting for demographic and health care-related characteristics. Results: During 2013-2021, 131,900 dementia-related health care encounters in Southern Nevada from both inpatient and outpatient visits occurred. Only 6% (n = 8,490) of dementia health care utilizers in Southern Nevada were discharged to hospice, which differed by racial and ethnic minority groups (p < 0.001). Black, Asian Pacific Islander, and Hispanic/Latino older adults living with dementia had between 15% to 26% lower odds of being discharged to hospice compared with their White counterparts. Age, gender, health insurance type, and inpatient encounters and year were also significantly associated with being discharged to hospice. Conclusions and Relevance: Findings from this study highlight the need to better understand potential disparities in access to hospice care among racial and ethnic minority communities living with dementia. Interventions to improve equitable access to hospice care among diverse populations in Southern Nevada should be explored.