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Persistence of Racial Disparities in Advance Care Plan Documents Among Nursing Home Residents
Author(s) -
Degenholtz Howard B.,
Arnold Robert A.,
Meisel Alan,
Lave Judith R.
Publication year - 2002
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2002.50073.x
Subject(s) - medicine , nursing homes , living wills , gerontology , family medicine , medical expenditure panel survey , race (biology) , assisted living facility , long term care , nursing , health care , health insurance , botany , economics , biology , economic growth
This paper analyzes the association between race and the presence of advance care plan documents (living wills, do not resuscitate (DNR) orders, and do not hospitalize (DNH) orders) in nursing home residents. We conducted secondary analysis of publicly available survey data from the 1996 Medical Expenditure Panel Survey—Nursing Home Component, a nationally representative survey of nursing home residents in the United States. There were 3,747 participants in the survey, weighted to represent 1.56 million nursing home residents in the United States. We found that 20% of U.S. nursing home residents in 1996 had documentation of living wills, 48% had DNR orders, and 4% had DNH orders. African Americans are about one‐third as likely as Caucasians to have living wills and one‐fifth as likely as Caucasians to have DNR orders; Hispanics are about one‐third as likely as Caucasians to have DNR orders and just as likely as Caucasians to have living wills. In conclusion, we found that the presence of advance care plans is related to race, even after controlling for health and other demographic factors. These findings call attention to an area where further research is needed to determine whether residents' (and their families') preferences are being elicited and documented.