Ethnic variation in timing of hospice referral: Does having no informal caregiver matter?
Ethnic variation in timing of hospice referral: Does having no informal caregiver matter?
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DOI：
10.1089/jpm.2007.0149
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发表时间：
2008-04-01
影响因子：
2.8
通讯作者：
Samson, Linda F.
中科院分区：
文献类型：
--
作者：
Chung, Kyusuk;Essex, Elizabeth;Samson, Linda F.
背景资料：临终关怀住院时间的长短，作为临终关怀转诊时间的指标，是一个重要的结果，以检查在生命终了护理，因为它是有关的质量和成本效益的生命终了护理，病人接受。虽然大多数人从非正式的照顾者那里接受非医疗护理，但许多老年临终关怀的使用者依赖于付费的照顾者或居住设施的工作人员。目的：本研究探讨了非正式的主要照顾者的可用性是否与种族相互作用，以影响临终关怀的停留时间。设计：一项回顾性横断面研究。设置/受试者：从美国国家卫生统计中心的全国家庭和临终关怀调查（NHHCS）中提取了1997年至2000年间出院的3024名65岁及以上临终关怀患者的数据。测量指标：死亡或出院前的临终关怀停留时间。生存分析显示，在有正式照顾者的患者中，少数民族患者的临终关怀时间可能比非西班牙裔白人短得多。有没有显着的种族差异，在住院时间长短的患者与非正式carrier.Conclusions：我们的研究结果表明，种族差异的住院时间长短应讨论的照顾者的类型，而不仅仅是类型的设置，因为患者在住宅设施可以有非正式的主要照顾者谁是他们垂死的亲属的警惕倡导者。我们讨论了可能的原因，有正式照顾者对少数民族老年人的逗留时间的影响。
Background: The length of hospice stay, as an indicator of timing of hospice referral, is an important outcome to examine in end-of-life care because it is relevant to the quality and cost efficiency of end-of-life care that patients receive. Although the majority receives nonmedical care from informal caregivers, many elderly hospice users rely on paid caregivers or staff of residential facilities.Objective: This study examined whether availability of informal primary caregiver interact with ethnicity to affect length of hospice stay.Design: A retrospective cross-sectional study.Setting/subjects: Data on 3024 hospice patients aged 65 and older discharged between 1997 and 2000 was extracted from the National Center for Health Statistics' National Home and Hospice Care Survey (NHHCS).Measurements: Length of hospice stay prior to death or discharge.Results: Survival analysis revealed that among patients with formal caregivers, minority patients were likely to have significantly shorter hospice stays than non-Hispanic whites. There were no significant ethnic differences in length of stay among patients with informal caregivers.Conclusions: Our findings suggest that ethnic differences in length of stay should be discussed in terms of type of caregiver, not just type of setting, since patients in residential facilities can have informal primary caregivers who are vigilant advocates for their dying relatives. We discuss possible reasons for the influence of having formal caregivers on length of stay of minority elders.