Racial disparities in hospice use

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PHILADELPHIA, Dec. 26 (UPI) -- Rules on hospice care for those with limited life expectancy restrict usage by those most in need, disproportionately affecting blacks, U.S. researchers said.

The study, scheduled to be published in the Feb. 1 issue of Cancer, said eligibility criteria for hospice services should be reconsidered.

To enroll in hospice, patients must have a prognosis of six months or less if their illness runs its usual course. They must also accept the palliative nature -- reducing the severity of symptoms instead of striving to cure the disease -- of hospice care.

Dr. David Casarett and colleagues at the University of Pennsylvania interviewed 283 patients who were receiving cancer treatment at six oncology clinics.

Patients were asked about their perceived need for five hospice services and their preferences for continuing cancer treatment, and they were followed for six months or until death.

Casarett's team found that African-American patients had stronger preferences for continuing their cancer treatments as well as greater perceived needs for hospice services -- poorer patients wanted more services.

"These findings suggest that the hospice eligibility criteria of Medicare and other insurers requiring patients to give up cancer treatment contribute to racial disparities in hospice use," the study authors said in a statement. "Moreover, these criteria do not select those patients with the greatest needs for hospice services."