Racial Differences in Palliative Care Use in Heart Failure Decedents.

Background: Minoritized individuals experience greater heart failure (HF) incidence and mortality rates, yet racial disparities in palliative care (PC) in HF are unknown.

Methods: This retrospective study used electronic medical records to identify adults who were hospitalized at an academic health system and died due to HF between 2012 and 2018. Using multivariable logistic regression, we examined associations between decedents' characteristics and PC consultations (PCCs).

Social Deprivation and End-of-Life Care Use Among Adults With Cancer.

Purpose: Socioeconomic differences are partially responsible for racial inequities in cancer outcomes, yet the association of area-level socioeconomic disadvantage and race with end-of-life (EOL) cancer care quality is poorly understood.

Methods: This retrospective study used electronic medical records from an academic health system to identify 33,635 adults with cancer who died between 2013 and 2019. Using multivariable logistic regression, we examined associations between decedent characteristics and EOL care, including emergency department (ED) visits, intensive care unit (ICU) stays, palliative care consultation (PCC), hospice order, and in-hospital deaths.

Public Health and Palliative Care.

Meeting the needs of people at the end of life (EOL) is a public health (PH) concern, yet a PH approach has not been widely applied to EOL care. The design of hospice in the United States, with its focus on cost containment, has resulted in disparities in EOL care use and quality. Individuals with non-cancer diagnoses, minoritized individuals, individuals of lower socioeconomic status, and those who do not yet qualify for hospice are particularly disadvantaged by the existing hospice policy.

Racial Differences in Firearms Used and Autopsies Following Gun Deaths Exist.

Introduction: Disparities in gun violence across race are well documented. Studying these disparities is essential to reduce preventable gun deaths. This study evaluates the relationship between sociodemographic factors and firearms used in gun deaths.

Palliative Care for Patients With Heart Failure: Results From a Heart Failure Society of America Survey.

Background: Multiple guidelines recommend specialty palliative care (PC) for patients with heart failure (HF), including patients with left ventricular assist devices (LVADs). However, the degree of integration and clinicians' perceptions of PC in HF care remain incompletely characterized.

Methods And Results: A 36-item survey was sent to 2109 members of the Heart Failure Society of America.

Trends in Location of Death Among Older Adult Americans After Falls.

Fall-related mortality is increasing among older adults, yet trends and changes in the location of fall-attributed deaths are unknown; additionally, potential disparities are understudied. To assess trends/factors associated with place of death among older adult fall deaths in the US, a cross-sectional analysis of deaths using mortality data from 2003-2017 was performed. Most deaths occurred in hospitals, however, the proportion decreased from 66.

Barriers of Acceptance to Hospice Care: a Randomized Vignette-Based Experiment.

Background: The per diem financial structure of hospice care may lead agencies to consider patient-level factors when weighing admissions.

Objective: To investigate if treatment cost, disease complexity, and diagnosis are associated with hospice willingness to accept patients.

Design: In this 2019 online survey study, individuals involved in hospice admissions decisions were randomized to view one of six hypothetical patient vignettes: "high-cost, high-complexity," "low-cost, high-complexity," and "low-cost, low-complexity" within two diseases: heart failure and cystic fibrosis.

Rural-Urban Disparities in Mortality From Cirrhosis in the United States From 1999 to 2019.

Introduction: We examined trends in rural-urban cirrhosis mortality disparities in the United States from decedents aged 25 years and older from 1999 to 2019.

Methods: We calculated cirrhosis age-adjusted mortality rates across 3 population categories: large metropolitan (≥1 million), medium/small metropolitan (50,000-999,999), and rural (<50,000) areas using the US Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research database.

Results: We found an almost 20-fold increase in the absolute difference in cirrhosis age-adjusted mortality rates between rural and large metropolitan areas between 1999 and 2019.

"That Little Bit of Time": Transition-to-Hospice Perspectives From Hospice Staff and Bereaved Family.

Background And Objectives: Many patients lack understanding of hospice services and their preparation for the transition to hospice at home may be insufficient. This study explored how hospice admissions staff and caregivers of hospice patients perceive the hospice admission process and the transition to hospice at home.

Research Design And Methods: We conducted in-depth, semistructured interviews with 2 subgroups: hospice admissions staff ( = 15) and bereaved caregivers of former hospice patients ( = 20).

Use of Theoretical Frameworks in the Development and Testing of Palliative Care Interventions.

Context: Palliative care (PC) research has grown over the last 20 years. Yet, the causal components and pathways of PC interventions remain unclear.

Objectives: To document the prevalence and application of theoretical frameworks in developing and testing PC interventions.

Rural-Urban Disparity in Mortality in the US From 1999 to 2019.

This study analyzes all deaths occurring in the US using the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from 1999-2019 and the National Center for Health Statistics Urban-Rural Classification Scheme to create population categories per the 2013 US Census classification (large, small- or medium-sized, and rural areas).

Evaluating the Contribution of Patient-Provider Communication and Cancer Diagnosis to Racial Disparities in End-of-Life Care Among Medicare Beneficiaries.

Background: The quality of end-of-life (EOL) care in the USA remains suboptimal, with significant variations in care by race and across disease subgroups. Patient-provider communication may contribute to racial and disease-specific variations in EOL care outcomes.

Objective: We examined racial disparities in EOL care, by disease group (cancer vs.

"He Needed Just About Everything": Caring for Aging Adults Postincarceration.

Methods: We conducted a thematic analysis on semi-structured interviews with 11 caregivers.

Results: Caregivers discussed how prior incarceration coupled with aging present barriers to housing, employment, and safety-net benefits-making caregiving more difficult. Caregivers assist their older care recipients to develop essential life skills (e.

National Trends in Hospice Facility Deaths in the United States, 2003-2017.

Context: Hospice facilities are increasingly preferred as a location of death, but little is known about the characteristics of patients who die in these facilities in the U.S.

Objectives: We sought to examine the trends and factors associated with death in a hospice facility.

Trends in Place of Death for Individuals With Deaths Attributed to Advanced Chronic or End-Stage Kidney Disease in the United States.

Context: An important aspect of end-of-life care, place of death is understudied in advanced chronic (CKD) and end-stage kidney disease (ESKD).

Objective: We sought to examine trends and factors associated with where advanced CKD/ESKD patients die.

Methods: We conducted a retrospective cross-sectional study using mortality data from 2003 to 2017 for deaths attributed primarily to advanced CKD/ESKD in the United States.

Rural-Urban Differences in Cardiovascular Mortality in the US, 1999-2017.

This study used data from the US Centers for Disease Control and Prevention WONDER database to examined temporal trends in cardiovascular disease age-adjusted mortality rates overall and across subgroups stratified by rural-urban area designation in the US.

Place of Death for Individuals With Chronic Lung Disease: Trends and Associated Factors From 2003 to 2017 in the United States.

Background: Although chronic lung disease is a common cause of mortality, little is known about where individuals with chronic lung disease die.

Research Question: The aim of this study was to determine the trends and factors associated with place of death among individuals with chronic lung disease.

Study Design And Methods: This cross-sectional analysis of natural deaths was conducted by using the Centers for Disease Control and Prevention Wide-ranging OnLine Data for Epidemiologic Research from 2003 to 2017 for which COPD, interstitial lung disease (ILD), or cystic fibrosis (CF) was the underlying cause.