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dc.contributor.authorClark, Melissa A.
dc.contributor.authorPerson, Sharina D.
dc.contributor.authorGosline, Anna
dc.contributor.authorGawande, Atul A.
dc.contributor.authorBlock, Susan D.
dc.date2022-08-11T08:10:35.000
dc.date.accessioned2022-08-23T17:13:28Z
dc.date.available2022-08-23T17:13:28Z
dc.date.issued2018-04-16
dc.date.submitted2018-06-27
dc.identifier.citation<p>J Palliat Med. 2018 Apr 16. doi: 10.1089/jpm.2017.0374. [Epub ahead of print] <a href="https://doi.org/10.1089/jpm.2017.0374">Link to article on publisher's site</a></p>
dc.identifier.issn1557-7740 (Linking)
dc.identifier.doi10.1089/jpm.2017.0374
dc.identifier.pmid29658817
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46736
dc.description.abstractBACKGROUND: Few studies have focused on racial and ethnic differences in advance care planning other than advance directives among population-based samples of adults across the lifespan. METHODS: Using data from a statewide random-digit dial telephone survey of adults 18 years or older (n = 1851), we investigated racial and ethnic differences in (1) designation of a healthcare agent (HCA); and (2) communication of goals, values, and preferences for end-of-life care with healthcare providers, a HCA, or other family members and friends. RESULTS: Less than half (44%, 95% confidence interval [CI] = 41.3%-47.0%) of all participants had named a HCA. In multivariable analyses, participants who identified as Hispanic (adjusted odds ratio [aOR] = 0.4, 95% CI = 0.2-0.7) or non-Hispanic other (aOR = 0.6, 95% CI = 0.4-0.9) were less likely than non-Hispanic whites to have named a HCA. Only 14.5% (95% CI = 12.6%-16.5%) of all participants had ever had a conversation with a healthcare provider about their end-of-life care wishes, with no differences by race/ethnicity. Over half (53.9%, 95% CI = 51.0%-56.8%) of all participants reported having had conversations with someone other than a healthcare provider about their end-of-life wishes. In multivariable analyses, non-Hispanic whites were more likely than Hispanics (aOR = 0.5, 95% CI = 0.3-0.7), black/African Americans (aOR = 0.5, 95% CI = 0.3-0.9), and non-Hispanic others (aOR = 0.7, 95% CI = 0.5-1.0) to report having had such conversations. CONCLUSIONS: Racial and ethnic minorities may be disadvantaged in the quality of care they receive if they have a serious illness and are unable to make decisions for themselves because most have not talked to anyone about their goals, values, or preferences for care.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29658817&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1089/jpm.2017.0374
dc.subjectadvance care planning
dc.subjectadvance directive adherence
dc.subjectcross-cultural comparison
dc.subjectEpidemiology
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectPalliative Care
dc.subjectRace and Ethnicity
dc.titleRacial and Ethnic Differences in Advance Care Planning: Results of a Statewide Population-Based Survey
dc.typeJournal Article
dc.source.journaltitleJournal of palliative medicine
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1195
dc.identifier.contextkey12399213
html.description.abstract<p>BACKGROUND: Few studies have focused on racial and ethnic differences in advance care planning other than advance directives among population-based samples of adults across the lifespan.</p> <p>METHODS: Using data from a statewide random-digit dial telephone survey of adults 18 years or older (n = 1851), we investigated racial and ethnic differences in (1) designation of a healthcare agent (HCA); and (2) communication of goals, values, and preferences for end-of-life care with healthcare providers, a HCA, or other family members and friends.</p> <p>RESULTS: Less than half (44%, 95% confidence interval [CI] = 41.3%-47.0%) of all participants had named a HCA. In multivariable analyses, participants who identified as Hispanic (adjusted odds ratio [aOR] = 0.4, 95% CI = 0.2-0.7) or non-Hispanic other (aOR = 0.6, 95% CI = 0.4-0.9) were less likely than non-Hispanic whites to have named a HCA. Only 14.5% (95% CI = 12.6%-16.5%) of all participants had ever had a conversation with a healthcare provider about their end-of-life care wishes, with no differences by race/ethnicity. Over half (53.9%, 95% CI = 51.0%-56.8%) of all participants reported having had conversations with someone other than a healthcare provider about their end-of-life wishes. In multivariable analyses, non-Hispanic whites were more likely than Hispanics (aOR = 0.5, 95% CI = 0.3-0.7), black/African Americans (aOR = 0.5, 95% CI = 0.3-0.9), and non-Hispanic others (aOR = 0.7, 95% CI = 0.5-1.0) to report having had such conversations.</p> <p>CONCLUSIONS: Racial and ethnic minorities may be disadvantaged in the quality of care they receive if they have a serious illness and are unable to make decisions for themselves because most have not talked to anyone about their goals, values, or preferences for care.</p>
dc.identifier.submissionpathqhs_pp/1195
dc.contributor.departmentDepartment of Quantitative Health Sciences


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