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Regional Practice Patterns and Racial/Ethnic Differences in Intensity of End-of-Life Care.
Health Services Research 2018 December
OBJECTIVE: To examine whether regional practice patterns impact racial/ethnic differences in intensity of end-of-life care for cancer decedents.
DATA SOURCES: The linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database.
STUDY DESIGN: We classified hospital referral regions (HRRs) based on mean 6-month end-of-life care expenditures, which represented regional practice patterns. Using hierarchical generalized linear models, we examined racial/ethnic differences in the intensity of end-of-life care across levels of HRR expenditures.
PRINCIPAL FINDINGS: There was greater variation in intensity of end-of-life care among Hispanics, Asians, and whites in high-expenditure HRRs than in low-expenditure HRRs.
CONCLUSIONS: Local practice patterns may influence racial/ethnic differences in end-of-life care.
DATA SOURCES: The linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database.
STUDY DESIGN: We classified hospital referral regions (HRRs) based on mean 6-month end-of-life care expenditures, which represented regional practice patterns. Using hierarchical generalized linear models, we examined racial/ethnic differences in the intensity of end-of-life care across levels of HRR expenditures.
PRINCIPAL FINDINGS: There was greater variation in intensity of end-of-life care among Hispanics, Asians, and whites in high-expenditure HRRs than in low-expenditure HRRs.
CONCLUSIONS: Local practice patterns may influence racial/ethnic differences in end-of-life care.
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