Referral and utilization patterns for home-based palliative care services among older adults

Home-based palliative care (HPC) improves quality of life for individuals with serious illness but remains underutilized in the United States, with persistent disparities in access. HPC is also frequently misconceived as appropriate only at the end of life.

This study examined disparities in access to HPC by comparing patients who received services with those who were referred but not enrolled.

A secondary analysis was conducted using 567 clinical records from a healthcare facility in the eastern United States between 2022 and 2023. Descriptive statistics, chi-square tests, and Cox proportional hazards regression model were used to compare demographic and clinical characteristics between groups.

No significant differences were observed by gender or race between patients who received HPC and those who did not. Significant differences were found for age (t = 2.33, p = 0.02), insurance type (p < 0.001), and referral source (p = 0.02). Patients who received HPC were more likely to be older, female, insured through Medicare Part B, and referred from larger hospitals.

These findings underscore ongoing structural disparities in access to home-based palliative care and highlight the need for targeted strategies to improve equitable access to HPC services.