Sociodemographic disparities in the use of hospice by U.S. nursing home residents: A systematic review

Sociodemographic disparities in the use of hospice by U.S. nursing home residents: A systematic review
American Journal of Hospice and Palliative Medicine; Christine E. DeForge, PhD, RN, CCRN; Hsin S. Ma, MPP, MA; Andrew W. Dick, PhD; Patricia W. Stone, PhD, RN, FAAN, CIC; Gregory N. Orewa, PhD; Lara Dhingra, PhD; Russell Portenoy, MD; Denise D. Quigley, PhD, MA; 1/25
Hospice can improve end-of-life (EOL) outcomes in U.S. nursing homes (NHs). However, only one-third of eligible residents enroll, and substantial variation exists within and across NHs related to resident-, NH-, or community-level factors. Studies adjusting for resident-, NH-, and community-level factors found lower hospice use among male residents, Black/Non-White residents, and residents of rural NHs, with mixed results by payor and ownership. Results were mixed for hospice referral and length-of-stay. These findings suggest complex influences on NH hospice use.