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End of Life Health Disparities: Exam...

Thiede, Elizabeth.

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End of Life Health Disparities: Examining County-Level and Individual-Level Correlates of Hospice Care and Availability.

Record Type:	Electronic resources : Monograph/item
Title/Author:	End of Life Health Disparities: Examining County-Level and Individual-Level Correlates of Hospice Care and Availability./
Author:	Thiede, Elizabeth.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
Description:	169 p.
Notes:	Source: Dissertations Abstracts International, Volume: 85-05, Section: B.
Contained By:	Dissertations Abstracts International85-05B.
Subject:	Health disparities. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30720628
ISBN:	9798380727501

End of Life Health Disparities: Examining County-Level and Individual-Level Correlates of Hospice Care and Availability.
Thiede, Elizabeth.

End of Life Health Disparities: Examining County-Level and Individual-Level Correlates of Hospice Care and Availability. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 169 p.

Source: Dissertations Abstracts International, Volume: 85-05, Section: B.

Thesis (Ph.D.)--The Pennsylvania State University, 2023.

This item must not be sold to any third party vendors.

Hospice care is a specialized form of healthcare for individuals approaching the end of life. Hospice care is increasingly recognized as a means to improve quality of life in the days, weeks, and months prior to death. As a result, use of hospice care prior to death, especially for older adults, has increased dramatically over the last two decades. Concerns about hospice quality emerged as the hospice industry changed to meet increased demand among the growing older adult population. Following this development, the Centers for Medicare and Medicaid (CMS) created the Hospice Quality Reporting Program (HQRP).This relatively new hospice quality oversight program provides the opportunity to examine hospice care quality disparities using measures of both care processes and patient outcomes (measured as patient experience and satisfaction). The purpose of this study is to combine data from the HQRP with county-level sociodemographic data to explore potential spatial and social disparities in access to hospice care (e.g., availability of hospice care) and quality of available hospice. The first aim of this study is to explore county-level sociodemographic correlates of hospice availability and quality, while the second aim of the study is to stratify counties by rural or urban status to draw comparisons between rural and urban county correlates of hospice care availability and quality. The final aim of this study is to explore the relationship between individual-level sociodemographic characteristics and the quality score of the hospice from which care was received.This secondary, population-level analysis combines data from the HQRP with United States Census Bureau data and estimates a series of linear regression models to explore the relationships between county-level and individual-level correlates of hospice care quality. The study's results showed statistically significant relationships between county-level sociodemographic characteristics - including age, educational attainment, racial/ethnic composition, and poverty rate - and hospice availability. These relationships were largely similar across both rural and urban counties. This study also found statistically significant relationships between these county-level sociodemographic characteristics and the quality of availability; however, these relationships varied across the different measures of quality.The findings of this study suggest that using traditional county-level sociodemographic characteristics to examine disparities in hospice care availability and quality may not be sensitive to the specific characteristics of the unique subpopulation of older adults using hospice care. As a result, this study provides valuable insight into the science of end-of-life healthcare disparities that can inform future research and ultimately impact policy and practice.

ISBN: 9798380727501Subjects--Topical Terms:

3541398
Health disparities.
Subjects--Index Terms:

Hospice care

End of Life Health Disparities: Examining County-Level and Individual-Level Correlates of Hospice Care and Availability.
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500 $a Source: Dissertations Abstracts International, Volume: 85-05, Section: B.
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520 $a Hospice care is a specialized form of healthcare for individuals approaching the end of life. Hospice care is increasingly recognized as a means to improve quality of life in the days, weeks, and months prior to death. As a result, use of hospice care prior to death, especially for older adults, has increased dramatically over the last two decades. Concerns about hospice quality emerged as the hospice industry changed to meet increased demand among the growing older adult population. Following this development, the Centers for Medicare and Medicaid (CMS) created the Hospice Quality Reporting Program (HQRP).This relatively new hospice quality oversight program provides the opportunity to examine hospice care quality disparities using measures of both care processes and patient outcomes (measured as patient experience and satisfaction). The purpose of this study is to combine data from the HQRP with county-level sociodemographic data to explore potential spatial and social disparities in access to hospice care (e.g., availability of hospice care) and quality of available hospice. The first aim of this study is to explore county-level sociodemographic correlates of hospice availability and quality, while the second aim of the study is to stratify counties by rural or urban status to draw comparisons between rural and urban county correlates of hospice care availability and quality. The final aim of this study is to explore the relationship between individual-level sociodemographic characteristics and the quality score of the hospice from which care was received.This secondary, population-level analysis combines data from the HQRP with United States Census Bureau data and estimates a series of linear regression models to explore the relationships between county-level and individual-level correlates of hospice care quality. The study's results showed statistically significant relationships between county-level sociodemographic characteristics - including age, educational attainment, racial/ethnic composition, and poverty rate - and hospice availability. These relationships were largely similar across both rural and urban counties. This study also found statistically significant relationships between these county-level sociodemographic characteristics and the quality of availability; however, these relationships varied across the different measures of quality.The findings of this study suggest that using traditional county-level sociodemographic characteristics to examine disparities in hospice care availability and quality may not be sensitive to the specific characteristics of the unique subpopulation of older adults using hospice care. As a result, this study provides valuable insight into the science of end-of-life healthcare disparities that can inform future research and ultimately impact policy and practice.
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650 4 $a Older people. $3 761975
650 4 $a Health care policy. $3 3550686
650 4 $a Minority & ethnic groups. $3 3422415
650 4 $a Mortality. $3 533218
650 4 $a Gender identity. $3 523751
650 4 $a Health sciences. $3 3168359
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653 $a Hospice quality
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