Racial and Ethnic Differences in Advance Care Planning: Identifying Subgroup Patterns and Obstacles
Racial and Ethnic Differences in Advance Care Planning: Identifying Subgroup Patterns and Obstacles
复制标题
DOI：
10.1177/0898264312449185
复制
发表时间：
2012-09-01
影响因子：
2.8
通讯作者：
Carr, Deborah
中科院分区：
文献类型：
--
作者：
Carr, Deborah
目标：作者调查了 (a) 白人、黑人、拉丁裔和亚洲人的预先护理计划 (ACP；即生前意愿、医疗保健代理、讨论) 的比率是否存在差异，(b) 种族群体内异质性的来源，以及 (c) 不进行 ACP 的解释中的种族差异。方法：作者利用知识网络研究中 18 至 64 岁已婚和同居成年人的全国样本数据（N = 2,111）估计了逻辑回归模型。结果：拉丁裔比白人更不可能讨论偏好和拥有生前遗嘱，尽管后者的差距完全是由教育造成的。与白人相比，亚洲人不太可能进行讨论，但更有可能拥有生前遗嘱。黑人与白人之间的差异仅出现在低 SES（社会经济地位）亚群体中。每个小组都指出了规划的独特障碍。讨论：公共政策应针对在重大健康问题出现之前提高所有成年人 ACP 发生率的目标。
Objectives: The author investigated (a) whether Whites, Blacks, Latinos, and Asians differ in their rates of advance care planning (ACP; that is, living will, health care proxies, discussions), (b) sources of within-racial group heterogeneity, and (c) racial differences in the explanations offered for not doing ACP. Methods: The author estimated logistic regression models with data from a national sample of married and cohabiting adults ages 18 to 64 in the Knowledge Networks study (N = 2,111). Results: Latinos are less likely than Whites to discuss preferences and to have a living will, although the latter gap is fully accounted for by education. Asians are less likely than Whites to have discussions, but more likely to have living wills. Black-White differences emerge only among low SES (socioeconomic status) subgroups. Each group noted distinctive obstacles to planning. Discussion: Public policies should target increasing rates of ACP for all adults prior to onset of major health concerns.