Characteristics Associated With Mexican-American Hospice Use: Retrospective Cohort Study Using the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE).
Victoria Shepard, Soham Al Snih, Rebecca Burke and 4 others
PMID 35731552WHAT IT FOUND
Hospice use among older Mexican-Americans increased from 2004 to 2016, yet 38.4% of those entering hospice stayed 7 days or less.
Dying in Arizona or New Mexico, or having dementia, was linked to more hospice use.
Key findings
01The study analysed 970 Mexican-American decedents in the primary cohort and 403 in a survey-linked secondary cohort.
02Hospice use increased between 2004 and 2016, and 38.4% of decedents who used hospice stayed 7 days or less.
03Decedents with dementia or who died in Arizona or New Mexico were more likely to use hospice than those dying in Colorado or Texas.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study looked only at Mexican-Americans aged 75 or older who died between 2004 and 2016 and were Medicare beneficiaries, so it may not apply to younger Mexican-Americans, undocumented immigrants, or other Hispanic groups. Dementia diagnosis from Medicare records may have been underdiagnosed, because more participants in the survey-linked cohort had cognitive impairment than had a recorded dementia diagnosis. The analysis is observational and cannot show that dementia, geography, or any other factor caused hospice use. The secondary cohort required a survey within 2 years of death and complete data, which may exclude people with very poor health or no recent survey. State differences in hospice use and length of stay may reflect access, coding, or regional care patterns rather than patient preferences.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read the 38.4% short hospice stay as proof that families chose short stays. The study did not measure preferences, and the measured differences in length of stay were not statistically significant in the multivariate model.