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Regional Practice Patterns and Racial/Ethnic Differences in Intensity of End‐of‐Life Care
Author(s) -
Wang ShiYi,
Hsu Sylvia H.,
Huang Siwan,
Doan Kathy C.,
Gross Cary P.,
Ma Xiaomei
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12998
Subject(s) - ethnic group , end of life care , referral , medicine , demography , epidemiology , gerontology , multilevel model , palliative care , family medicine , nursing , sociology , anthropology , machine learning , computer science
Objective To examine whether regional practice patterns impact racial/ethnic differences in intensity of end‐of‐life care for cancer decedents. Data Sources The linked Surveillance, Epidemiology, and End Results ( SEER )‐Medicare database. Study Design We classified hospital referral regions ( HRR s) based on mean 6‐month end‐of‐life care expenditures, which represented regional practice patterns. Using hierarchical generalized linear models, we examined racial/ethnic differences in the intensity of end‐of‐life care across levels of HRR expenditures. Principal Findings There was greater variation in intensity of end‐of‐life care among Hispanics, Asians, and whites in high‐expenditure HRR s than in low‐expenditure HRR s. Conclusions Local practice patterns may influence racial/ethnic differences in end‐of‐life care.