MONDAY, Dec. 18, 2023 (HealthDay News) — Racial and ethnic disparities are seen in use of hospice among Medicaid recipients, according to a study published online Dec. 8 in JAMA Health Forum.
Julie Robison, Ph.D., from the UConn Health Center on Aging in Farmington, and colleagues compared hospice use and hospice length of stay (LOS) by race and ethnicity among Medicaid-only individuals and those with dual eligibility for Medicare and Medicaid (duals). The analysis included 2,407 individuals and 23,857 duals enrolled in the Connecticut Medicaid program who died.
The researchers found that race and ethnicity were significantly associated with hospice use and LOS in both populations. Non-Hispanic Black and Hispanic decedents had lower odds of using hospice compared with non-Hispanic White decedents. Hispanic decedents also had higher odds of a short LOS. In both populations, hospice use was associated with older age and female sex. Older age was associated with lower odds of short LOS in duals. For decedents with nursing facility stays, Medicaid-only decedents had higher odds of using hospice (odds ratio, 1.49), while duals had lower odds (odds ratio, 0.60) compared with those without nursing facility stays.
“These findings raise concerns about equity and timing of access to hospice for both Medicaid populations, particularly for Hispanic and non-Hispanic Black decedents, and suggest further analysis of the role of nursing facility stays,” the authors write.
The authors disclosed that the data for much of the work came from the Connecticut Department of Social Services, and the results have implications for the Department of Social Services policy, which could be perceived as influencing the study.
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