Ethnic Differences in In-Hospital Place of Death Among Older Adults in California

BACKGROUND: : Substantial ethnic differences have been reported in the probability that death will occur in a hospital setting rather than at home, in a hospice, or in a nursing home. To date, no study has investigated the role of both individual characteristics and contextual characteristics, including local health care environments, to explain ethnic differentials in end-of-life care. OBJECTIVES: : The study purpose is to examine ethnic differences in the association between death as a hospital in-patient and individual and contextual characteristics, as well as medical resource supply. RESEARCH DESIGN: : This study employed a secondary data analysis. SUBJECTS: : We used data from the California Death Statistical Master file for the years 1999-2001, which included 472,382 complete cases. These data were geocoded and linked to data from the US Census Bureau and the American Hospital Association. RESULTS: : Death as an in-patient was most common for Asian (54%) and Hispanic immigrants (49%) and least common for non-Hispanic whites (36%) and US-born Asians (41%). Medical resource supply variables are of considerable importance in accounting for ethnic differentials in the probability of dying in a hospital. Residual differences in in-hospital site of death were largest for immigrant populations. CONCLUSIONS: : There are sizeable ethnic differentials in the probability that a death will occur in a hospital in California. These differences are substantially mediated by sociodemographic characteristics of the decedent and local medical care supply. One implication of these findings is that variation exists in the efficiency and quality of end of life care delivered to ethnic minorities

Cause of death · Census · Disease · Environmental health · Ethnic group · Geography · Health care · Immigration · Population · Sociology · Demography · Grief, Bereavement, and Mental Health · Medicine · Organ Donation and Transplantation · Palliative Care and End-of-Life Issues · Gerontology

• Adult mortality in sub-saharan Africa, Zambia

  Open Access•Vesper Hichilombwe Chisumpa, Clifford O Odimegwu et al.•SSM - Population Health•2017

  Añadir item

• Who You Are and Where You Live

  Amitabh Chandra•Medical Care•2009

  Añadir item

• Current Research Findings on End-of-Life Decision Making Among Racially or Ethnically Diverse Groups

  Jung Kwak, William E Haley•The Gerontologist•2005

  Añadir item

• Where do the elderly die? The impact of nursing home utilisation on the place of death. Observations from a mortality cohort study in Flanders

  Open Access•Gilberte Van Rensbergen, Tim S Nawrot et al.•BMC Public Health•2006

  Añadir item

• Influence of individual and neighbourhood socioeconomic status on mortality among black, Mexican-American, and white women and men in the United States

  Marilyn A Winkleby, C Cubbin•Journal of Epidemiology and…•2003

  Añadir item

• The Roles of Citizenship Status, Acculturation, and Health Insurance in Breast and Cervical Cancer Screening Among Immigrant Women

  Sandra E Echeverria, Olveen Carrasquillo•Medical Care•2006

  Añadir item

• Explaining Racial and Ethnic Disparities in Health Care

  James B Kirby, Gregg Taliaferro et al.•Medical Care•2006

  Añadir item

• Factors Associated With Site of Death

  Sherry Weitzen, Eva Aladro Vico et al.•Medical Care•2003

  Añadir item

• Ethnicity and attitudes towards life sustaining technology

  Open Access•Leslie J Blackhall, Leslie Blackhall et al.•Social Science & Medicine•1999

  Añadir item

• Neighborhood Socioeconomic Disadvantage and Access to Health Care

  Open Access•James B Kirby, Toshiko Kaneda•Journal of Health and Social…•2005

  Añadir item