African American bereaved family members' perceptions of hospice quality

Do hospices with high proportions of African Americans do better?

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Research suggests that racial differences in end-of-life care persist even among patients enrolled in hospice. Objective: The objective of the study was to examine the association between bereaved family members' satisfaction with hospice services and the proportion of African American (AA) patients in hospice. Methods: The 2007 and 2008 Family Evaluation of Hospice Care (FEHC) Survey examined family members' perceptions of the quality of care on several dimensions including: unmet need for pain, dyspnea, and emotional support; being informed about the patient's condition and what to expect as the patient was dying; being informed about medications and treatments for symptoms; coordination of care; and overall satisfaction with care. We examined the association between family members' perception along each domain and the proportion of AAs served by hospices surveyed. Results: Of the 11,892 AA decedents in 678 hospice programs, 53.7% were female. The leading cause of death was cancer (51.6%). On univariate analysis, family members of decedents who died in hospices that had higher proportions of AAs were less likely to have concerns about unmet pain needs (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.72-0.98), more likely to have concerns about coordination of care (1.28, 1.17-1.40), and less likely to perceive care as excellent or very good (0.73, 0.63-0.84). Coordination-of-care concerns and lower overall rating of care persisted in multivariable analyses. There were no other significant associations between family perceptions and proportions of AAs in hospice. Conclusions: Among hospices with higher proportions of AAs, family members have more concerns about coordination of care and have lower overall perceptions of quality.

Original languageEnglish (US)
Pages (from-to)1137-1141
Number of pages5
JournalJournal of Palliative Medicine
Volume15
Issue number10
DOIs
StatePublished - Oct 1 2012

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Hospices
African Americans
Hospice Care
Pain
Terminal Care
Quality of Health Care
Dyspnea
Cause of Death
Odds Ratio
Confidence Intervals
Research

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

@article{25e57eefcd574b9488a24fe66573092a,
title = "African American bereaved family members' perceptions of hospice quality: Do hospices with high proportions of African Americans do better?",
abstract = "Background: Research suggests that racial differences in end-of-life care persist even among patients enrolled in hospice. Objective: The objective of the study was to examine the association between bereaved family members' satisfaction with hospice services and the proportion of African American (AA) patients in hospice. Methods: The 2007 and 2008 Family Evaluation of Hospice Care (FEHC) Survey examined family members' perceptions of the quality of care on several dimensions including: unmet need for pain, dyspnea, and emotional support; being informed about the patient's condition and what to expect as the patient was dying; being informed about medications and treatments for symptoms; coordination of care; and overall satisfaction with care. We examined the association between family members' perception along each domain and the proportion of AAs served by hospices surveyed. Results: Of the 11,892 AA decedents in 678 hospice programs, 53.7{\%} were female. The leading cause of death was cancer (51.6{\%}). On univariate analysis, family members of decedents who died in hospices that had higher proportions of AAs were less likely to have concerns about unmet pain needs (odds ratio [OR] 0.84, 95{\%} confidence interval [CI] 0.72-0.98), more likely to have concerns about coordination of care (1.28, 1.17-1.40), and less likely to perceive care as excellent or very good (0.73, 0.63-0.84). Coordination-of-care concerns and lower overall rating of care persisted in multivariable analyses. There were no other significant associations between family perceptions and proportions of AAs in hospice. Conclusions: Among hospices with higher proportions of AAs, family members have more concerns about coordination of care and have lower overall perceptions of quality.",
author = "Rhodes, {Ramona L.} and Lei Xuan and Halm, {Ethan A.}",
year = "2012",
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language = "English (US)",
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TY - JOUR

T1 - African American bereaved family members' perceptions of hospice quality

T2 - Do hospices with high proportions of African Americans do better?

AU - Rhodes, Ramona L.

AU - Xuan, Lei

AU - Halm, Ethan A.

PY - 2012/10/1

Y1 - 2012/10/1

N2 - Background: Research suggests that racial differences in end-of-life care persist even among patients enrolled in hospice. Objective: The objective of the study was to examine the association between bereaved family members' satisfaction with hospice services and the proportion of African American (AA) patients in hospice. Methods: The 2007 and 2008 Family Evaluation of Hospice Care (FEHC) Survey examined family members' perceptions of the quality of care on several dimensions including: unmet need for pain, dyspnea, and emotional support; being informed about the patient's condition and what to expect as the patient was dying; being informed about medications and treatments for symptoms; coordination of care; and overall satisfaction with care. We examined the association between family members' perception along each domain and the proportion of AAs served by hospices surveyed. Results: Of the 11,892 AA decedents in 678 hospice programs, 53.7% were female. The leading cause of death was cancer (51.6%). On univariate analysis, family members of decedents who died in hospices that had higher proportions of AAs were less likely to have concerns about unmet pain needs (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.72-0.98), more likely to have concerns about coordination of care (1.28, 1.17-1.40), and less likely to perceive care as excellent or very good (0.73, 0.63-0.84). Coordination-of-care concerns and lower overall rating of care persisted in multivariable analyses. There were no other significant associations between family perceptions and proportions of AAs in hospice. Conclusions: Among hospices with higher proportions of AAs, family members have more concerns about coordination of care and have lower overall perceptions of quality.

AB - Background: Research suggests that racial differences in end-of-life care persist even among patients enrolled in hospice. Objective: The objective of the study was to examine the association between bereaved family members' satisfaction with hospice services and the proportion of African American (AA) patients in hospice. Methods: The 2007 and 2008 Family Evaluation of Hospice Care (FEHC) Survey examined family members' perceptions of the quality of care on several dimensions including: unmet need for pain, dyspnea, and emotional support; being informed about the patient's condition and what to expect as the patient was dying; being informed about medications and treatments for symptoms; coordination of care; and overall satisfaction with care. We examined the association between family members' perception along each domain and the proportion of AAs served by hospices surveyed. Results: Of the 11,892 AA decedents in 678 hospice programs, 53.7% were female. The leading cause of death was cancer (51.6%). On univariate analysis, family members of decedents who died in hospices that had higher proportions of AAs were less likely to have concerns about unmet pain needs (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.72-0.98), more likely to have concerns about coordination of care (1.28, 1.17-1.40), and less likely to perceive care as excellent or very good (0.73, 0.63-0.84). Coordination-of-care concerns and lower overall rating of care persisted in multivariable analyses. There were no other significant associations between family perceptions and proportions of AAs in hospice. Conclusions: Among hospices with higher proportions of AAs, family members have more concerns about coordination of care and have lower overall perceptions of quality.

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U2 - 10.1089/jpm.2012.0151

DO - 10.1089/jpm.2012.0151

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