Persistence of racial disparities in advance care plan documents among nursing home residents
Persistence of racial disparities in advance care plan documents among nursing home residents
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DOI：
10.1046/j.1532-5415.2002.50073.x
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发表时间：
2002-02-01
影响因子：
6.3
通讯作者：
Lave, JR
中科院分区：
文献类型：
--
作者：
Degenholtz, HB;Arnold, RA;Lave, JR
本文分析了疗养院居民的种族与预先护理计划文件（生前遗嘱；不复苏 (DNR) 指令和不住院 (DNH) 指令）之间的关联。我们对 1996 年医疗支出小组调查-疗养院部分的公开调查数据进行了二次分析，这是一项针对美国疗养院居民的全国代表性调查。此次调查共有 3,747 名参与者，代表了美国 156 万疗养院居民。我们发现，1996 年，20% 的美国疗养院居民拥有生前遗嘱文件，48% 拥有 DNR 令，4% 拥有 DNH 令。非裔美国人拥有生前遗嘱的可能性大约是白人的三分之一，拥有 DNR 命令的可能性是白人的五分之一；西班牙裔获得 DNR 命令的可能性约为白人的三分之一，而获得生前遗嘱的可能性与白人相同。总之，我们发现预先护理计划的存在与种族有关，即使在控制了健康和其他人口因素之后也是如此。这些发现引起人们对需要进一步研究的领域的关注，以确定居民（及其家人）的偏好是否被引出并记录下来。
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.