Race/Ethnicity as a Predictor for Location of Death in Patients With Acute Neurovascular Events

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. Methods: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services. The main outcome was location of death (palliative care inpatient unit [IPU] at the medical center or hospice services at discharge vs death on any other IPU). Results: A total of 655 patients admitted with acute neurovascular events from January 1, 2009, to March 1, 2015, died or were discharged with hospice services and were included in the analysis. Of those patients, 238 (36.3%) were black, 233 (35.5%) were Hispanic, and 184 (28.1%) were white. A total of 178 (24.4%) died on the palliative care unit or were discharged with hospice services, including 55 black patients (23.1%), 52 (28.3%) white patients, and 53 (22.7%) Hispanic patients. These differences were not statistically significant, even when controlling for confounders. Conclusion: This study did not show a difference in site of death in our institution by race or ethnicity, which is considered an important quality end-of-life care metric.

Original languageEnglish (US)
Pages (from-to)100-103
Number of pages4
JournalAmerican Journal of Hospice and Palliative Medicine
Volume35
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Hospices
Terminal Care
Palliative Care
Hispanic Americans
Inpatients
Quality of Life
Cerebral Hemorrhage
Subarachnoid Hemorrhage
General Hospitals
Cohort Studies
Retrospective Studies
Stroke

Keywords

  • health-care disparities
  • hospice care
  • nervous systems diseases
  • palliative care
  • stroke
  • terminal care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{cbe421010617478ab57b71aae77ee178,
title = "Race/Ethnicity as a Predictor for Location of Death in Patients With Acute Neurovascular Events",
abstract = "Background: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. Methods: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services. The main outcome was location of death (palliative care inpatient unit [IPU] at the medical center or hospice services at discharge vs death on any other IPU). Results: A total of 655 patients admitted with acute neurovascular events from January 1, 2009, to March 1, 2015, died or were discharged with hospice services and were included in the analysis. Of those patients, 238 (36.3{\%}) were black, 233 (35.5{\%}) were Hispanic, and 184 (28.1{\%}) were white. A total of 178 (24.4{\%}) died on the palliative care unit or were discharged with hospice services, including 55 black patients (23.1{\%}), 52 (28.3{\%}) white patients, and 53 (22.7{\%}) Hispanic patients. These differences were not statistically significant, even when controlling for confounders. Conclusion: This study did not show a difference in site of death in our institution by race or ethnicity, which is considered an important quality end-of-life care metric.",
keywords = "health-care disparities, hospice care, nervous systems diseases, palliative care, stroke, terminal care",
author = "Say Salomon and Chuang, {Elizabeth J.} and Deepa Bhupali and Labovitz, {Daniel L.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1177/1049909116687258",
language = "English (US)",
volume = "35",
pages = "100--103",
journal = "American Journal of Hospice and Palliative Medicine",
issn = "1049-9091",
publisher = "SAGE Publications Inc.",
number = "1",

}

TY - JOUR

T1 - Race/Ethnicity as a Predictor for Location of Death in Patients With Acute Neurovascular Events

AU - Salomon, Say

AU - Chuang, Elizabeth J.

AU - Bhupali, Deepa

AU - Labovitz, Daniel L.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. Methods: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services. The main outcome was location of death (palliative care inpatient unit [IPU] at the medical center or hospice services at discharge vs death on any other IPU). Results: A total of 655 patients admitted with acute neurovascular events from January 1, 2009, to March 1, 2015, died or were discharged with hospice services and were included in the analysis. Of those patients, 238 (36.3%) were black, 233 (35.5%) were Hispanic, and 184 (28.1%) were white. A total of 178 (24.4%) died on the palliative care unit or were discharged with hospice services, including 55 black patients (23.1%), 52 (28.3%) white patients, and 53 (22.7%) Hispanic patients. These differences were not statistically significant, even when controlling for confounders. Conclusion: This study did not show a difference in site of death in our institution by race or ethnicity, which is considered an important quality end-of-life care metric.

AB - Background: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. Methods: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services. The main outcome was location of death (palliative care inpatient unit [IPU] at the medical center or hospice services at discharge vs death on any other IPU). Results: A total of 655 patients admitted with acute neurovascular events from January 1, 2009, to March 1, 2015, died or were discharged with hospice services and were included in the analysis. Of those patients, 238 (36.3%) were black, 233 (35.5%) were Hispanic, and 184 (28.1%) were white. A total of 178 (24.4%) died on the palliative care unit or were discharged with hospice services, including 55 black patients (23.1%), 52 (28.3%) white patients, and 53 (22.7%) Hispanic patients. These differences were not statistically significant, even when controlling for confounders. Conclusion: This study did not show a difference in site of death in our institution by race or ethnicity, which is considered an important quality end-of-life care metric.

KW - health-care disparities

KW - hospice care

KW - nervous systems diseases

KW - palliative care

KW - stroke

KW - terminal care

UR - http://www.scopus.com/inward/record.url?scp=85035123311&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85035123311&partnerID=8YFLogxK

U2 - 10.1177/1049909116687258

DO - 10.1177/1049909116687258

M3 - Article

VL - 35

SP - 100

EP - 103

JO - American Journal of Hospice and Palliative Medicine

JF - American Journal of Hospice and Palliative Medicine

SN - 1049-9091

IS - 1

ER -