Associations of race and other socioeconomic factors with post-hospitalization hospice care settings.

OBJECTIVE: To examine patient characteristics post hospitalization between hospice home care and hospice care delivered in a medical facility. DESIGN, SETTING, AND PARTICIPANTS: A total of 3,613 hospital discharges to either hospice delivered at home or in a medical facility. Data was from the 2010 Nevada Hospital Inpatient Data. MAIN OUTCOME MEASURES: Our dependent variable was home-based hospice care and medical facility-based hospice care. Our independent variables included race which was categorized as White, African American, Hispanic/Latino, Asian/Pacific Islander, and other race/ethnicity. Socioeconomic factors were marital status and health insurance. RESULTS: Hispanic patients were more likely to be discharged to home rather than a facility-based hospice (OR 1.39). Single patients and divorced patients were less likely to be discharged to a home-based hospice setting (OR .79, .67). Older patients were more likely to be discharged to a facility-based hospice (OR .91). The presence of anemia, paralysis, neurological disorders and weight loss were negatively associated with home discharge (OR 1.51). Patients with higher charges were less likely to be discharged to home (OR .96). CONCLUSIONS: Race, age, diagnosis and marital status influenced whether patients were discharged to home-based hospice or hospice delivered in a medical facility. These findings will assist hospice in anticipating which setting would be most appropriate for patients. Further research to determine whether patient preferences or characteristics determine hospice setting will be beneficial.