Differences of Quality in End-of-Life Care across Settings: Results from the U.S. National Health and Aging Trends Study of Medicare Beneficiaries

Shuo Xu, Mangdong Liu, Oejin Shin, Vanessa Parker, Rosalba Hernandez

Research output: Contribution to journalArticlepeer-review

Abstract

Background: More than 2.5 million older Americans die each year. Place of residence in which dying patients receive care plays a crucial role in the quality of end-of-life (EOL) care. Objective: This study aimed to compare proxies' overall rating and ratings for 13 indicators across five major domains of EOL care by place of residence in the last month of decedents' lives. Design: We used data from the National Health and Aging Trends Study, a nationally representative study of Medicare beneficiaries at age 65 years and older in the United States. Setting/Subjects: Analyses included proxies (N = 1336) of Medicare beneficiaries who passed away between 2013 and 2016. Proxies were categorized into four groups, depending on place of residence in the last month of life and the involvement of hospice. Measurements: Quality of EOL care was assessed using questions modeled after quality of EOL care instruments. We adjusted for demographic data of decedents and proxies. Results: Hospice recipients, regardless of setting, were more likely to experience pain and talk about religion in the last month of life; families of patients without hospice in residential care settings were more likely to report not being kept informed; proxies of patients living in private residences with hospice care reported higher overall ratings. Among hospice recipients, those living in private residences were more likely to be treated with respect. Conclusions: Disparities exist across settings and in overall ratings for quality of EOL domains - particularly, the subdomains of symptom management, decision making, and spiritual needs.

Original languageEnglish (US)
Pages (from-to)1198-1203
Number of pages6
JournalJournal of palliative medicine
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2020

Keywords

  • home-based care
  • hospice
  • quality of end-of-life care
  • residential care

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Differences of Quality in End-of-Life Care across Settings: Results from the U.S. National Health and Aging Trends Study of Medicare Beneficiaries'. Together they form a unique fingerprint.

Cite this