Substitution of formal health care services by Latinos/Hispanics in the US-Mexico border region of South Texas.

Background: Pervasive poverty and high uninsurance rates in the US-Mexico border region coupled with rising US health care costs and the availability of alternatives to formal US health services-both in the United States and Mexico-have resulted in widespread use of alternatives to formal US health care.

Objectives: We investigate variation in the purchase of substitutes for formal US health services among border residents reporting health-related cost constraints. Preferences for various means of substitution (informal US services, formal Mexican services, and informal Mexican services) are identified.

What is patient safety culture? A review of the literature.

Purpose: To organize the properties of safety culture addressed by many studies and to develop a conceptual culture of safety model.

Design And Methods: A comprehensive review of the culture of safety literature within the U.S.

Ethnic differences in in-hospital place of death among older adults in California: effects of individual and contextual characteristics and medical resource supply.

Background: : Substantial ethnic differences have been reported in the probability that death will occur in a hospital setting rather than at home, in a hospice, or in a nursing home. To date, no study has investigated the role of both individual characteristics and contextual characteristics, including local health care environments, to explain ethnic differentials in end-of-life care.

Objectives: : The study purpose is to examine ethnic differences in the association between death as a hospital in-patient and individual and contextual characteristics, as well as medical resource supply.

Serum carotenoid levels vary by marital status.

This study examined differences in serum carotenoid levels by marital status. The design was a cross-sectional, nationally representative survey of 16,597 participants ages 18 years and older from the Third National Health and Nutrition Examination Survey. The main outcome measures were serum levels of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin, lycopene, and total carotenoids.

The association of marital status and hospice use in the USA.

Background: Married individuals are more likely to use hospice than unmarried individuals. We examine this association and how it is influenced by gender.

Methods: Medicare beneficiaries dying of cancer were studied.

Hospice use by Hispanic and non-Hispanic white cancer decedents.

Objective: To investigate rates of hospice use between Hispanic and non-Hispanic white Medicare beneficiaries diagnosed with cancer using data from a large, population-based study.

Data Sources: Secondary data from the linked SEER-Medicare database including the SEER areas of Los Angeles, San Francisco, and San Jose-Monterey, California, and the state of New Mexico. All subjects were Hispanic or non-Hispanic whites, aged 67 and older, had a cancer diagnosis of breast, colorectal, lung, or prostate cancer from 1991-1996, and died of cancer from 1991-1998.

Decreasing variation in the use of hospice among older adults with breast, colorectal, lung, and prostate cancer.

Background: Utilization of hospice services has been shown to vary by place of residence and patient characteristics.

Objectives: The purpose of this study was to examine whether such variation has changed over time. Hospice utilization is examined as a function of sociodemographic characteristics, geographic location, type of insurance, and year of death.

Hospice use by older women dying with breast cancer between 1991 and 1996.

The purpose of this study was to assess the use of hospice by women dying with breast cancer as a function of time period, geographic area, and patient characteristics. We used data from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database to study hospice care use in the United States in women aged 65 and older, diagnosed with breast cancer from 1986 to 1996, who died from 1991 to 1996. Of the 25,161 women who met those criteria, 5,198 (20.