Differences in Hospice Use Between Black and White Patients During the Period 1992 through 2000

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Abstract
We examined differences in hospice use rates among blacks and whites and investigated trends in racial differences in hospice patients during the period 1992 through 2000. We tested differences in length of hospice survival from hospice enrollment to death between black and white patients during this period. We analyzed data from the 1991–2000 Underlying and Multiple Cause-of-Death Files and the 1992–2000 National Home and Hospice Care Surveys using z tests, χ2 tests, and Cox regression models. Compared with 1992, the hospice use rate doubled for white patients (P Conclusions: Hospice use rates significantly increased for both whites and black patients. Black patients had lower hospice use rates than white patients from 1992 to 1994, but not from 1996 to 2000, which may reflect the diffusion of hospice care to black patients with the rapid growth in hospice programs. Despite differences in patient characteristics, the length of hospice survival was similar among both groups. Future research is needed to assess whether racial disparities exist in quality of hospice care.