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Background: Palliative care consultation to discuss goals-of-care ("PCC") may mitigate end-of-life care disparities.
Objective: To compare hospitalization and cost outcomes by race and ethnicity among PCC patients; identify predictors of hospice discharge and post-discharge hospitalization utilization and costs.
Methods: This secondary analysis of a retrospective cohort study assessed hospice discharge, do-not-resuscitate status, 30-day readmissions, days hospitalized, ICU care, any hospitalization cost, and total costs for hospitalization with PCC and hospitalization(s) post-discharge among 1,306 Black/African American, Latinx, White, and Other race PCC patients at a United States academic hospital.
Results: In adjusted analyses, hospice enrollment was less likely with Medicaid (AOR = 0.59, P = 0.02). Thirty-day readmission was less likely among age 75+ (AOR = 0.43, P = 0.02); more likely with Medicaid (AOR = 2.02, P = 0.004), 30-day prior admission (AOR = 2.42, P < 0.0001), and Black/African American race (AOR = 1.57, P = 0.02). Future days hospitalized was greater with Medicaid (Coefficient = 4.49, P = 0.001), 30-day prior admission (Coefficient = 2.08, P = 0.02), and Black/African American race (Coefficient = 2.16, P = 0.01). Any future hospitalization cost was less likely among patients ages 65-74 and 75+ (AOR = 0.54, P = 0.02; AOR = 0.53, P = 0.02); more likely with Medicaid (AOR = 1.67, P = 0.01), 30-day prior admission (AOR = 1.81, P = 0.0001), and Black/African American race (AOR = 1.40, P = 0.02). Total future hospitalization costs were lower for females (Coefficient = -3616.64, P = 0.03); greater with Medicaid (Coefficient = 7388.43, P = 0.01), 30-day prior admission (Coefficient = 3868.07, P = 0.04), and Black/African American race (Coefficient = 3856.90, P = 0.04). Do-not-resuscitate documentation (48%) differed by race.
Conclusions: Among PCC patients, Black/African American race and social determinants of health were risk factors for future hospitalization utilization and costs. Medicaid use predicted hospice discharge. Social support interventions are needed to reduce future hospitalization disparities.
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http://dx.doi.org/10.1177/10499091211034383 | DOI Listing |
J Racial Ethn Health Disparities
December 2024
Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, USA.
Objective(s): To identify trends in HIV diagnosis disparities among subpopulations of Black/African American and White persons by selected characteristics (i.e., sex assigned at birth, age group, and region of residence) in the United States during 2017‒2021.
View Article and Find Full Text PDFPregnancy Hypertens
December 2024
Section of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Chicago Medicine, IL, United States. Electronic address:
Objective: To describe postpartum visit attendance and postpartum blood pressure control among patients enrolled in a remote patient monitoring program and compare these outcomes by race.
Study Design: A prospective cohort study of postpartum patients with a diagnosis of hypertensive disorders of pregnancy at the University of Chicago between October 2021 and April 2022. All patients received remote patient monitoring as routine care but consented separately for the use of their data.
J Gen Intern Med
December 2024
Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, USA.
Background: With more than half of all beneficiaries enrolled in Medicare Advantage (MA) plans, ensuring access to high-quality MA plans is a key concern for policymakers. Access to high-quality MA plans may be limited in certain areas if private insurers are not willing to offer high-quality MA plans in local areas with greater unmet health-related social needs.
Objective: This study examined the association of a market-level social vulnerability index (SVI) score with the number of high-quality MA plans.
PLoS One
December 2024
A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, United States of America.
The objective of this study was to identify utilization of housing support provided by the U.S. Department of Housing and Urban Development (HUD) among autistic people in the U.
View Article and Find Full Text PDFJ Interpers Violence
December 2024
Boston University, MA, USA.
Technology-facilitated abuse (TFA) can result in long-term financial and mental health impacts on survivors. However, little research has been published to date about the types of costs and the economic burden that survivors of TFA experience. This study presents results from a U.
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