A recent study published in JAMA Network Open has uncovered significant disparities in hospice discharge rates and outcomes among Black and Hispanic patient populations compared to their white counterparts. The research, led by Elizabeth Luth, assistant professor at Rutgers University, examined data from over 115,000 Medicare fee-for-service decedents between 2014 and 2019.
The study found that Black and Hispanic patients are more likely to experience shorter hospice stays and be discharged into hospital settings. These populations also face a higher risk of burdensome care transitions and poor outcomes after leaving hospice care. Luth noted, “Black individuals are more likely to have a ‘revolving door’ experience: They are discharged alive, hospitalized and then readmitted to hospice.”
Approximately 15% of patients leave hospice before death, with 1-in-7 being either hospitalized or readmitted within two days of discharge. Patients identifying as Black or Hispanic, with hospice stays of seven days or less, showed the highest rates of rehospitalization or death after discharge.
The research highlights the impact of health inequities on access to quality end-of-life care for underserved populations. Luth emphasized the need for hospices to reconsider their approach to care for vulnerable patient groups.
The study suggests that increased use of general inpatient (GIP) and respite care, as well as systemic discharge planning, could help improve care transitions for Black and Hispanic populations. Luth stressed the importance of collaboration between hospices and other healthcare providers to address unmet needs among underserved populations and potentially adjust reimbursement structures to reduce high-cost healthcare utilization and readmission rates.
See “Study Finds Hospice Discharge Disparities Among Black, Hispanic Populations” (July 29, 2024)
