Persistence of racial disparities in advance care plan documents among nursing home residents

被引:127
作者
Degenholtz, HB
Arnold, RA
Meisel, A
Lave, JR
机构
[1] Univ Pittsburgh, Dept Hlth Serv Adm, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Dept Gen & Internal Med, Pittsburgh, PA 15213 USA
[3] Univ Pittsburgh, Sch Law, Pittsburgh, PA 15213 USA
[4] Univ Pittsburgh, Ctr Bioeth & Hlth Law, Pittsburgh, PA 15213 USA
关键词
advance care plans; living wills; DNR orders; DNH orders; nursing homes;
D O I
10.1046/j.1532-5415.2002.50073.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
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.
引用
收藏
页码:378 / 381
页数:4
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