Racial and Ethnic Differences in Advance Care Planning: Results of a Statewide Population-Based Survey
dc.contributor.author | Clark, Melissa A. | |
dc.contributor.author | Person, Sharina D. | |
dc.contributor.author | Gosline, Anna | |
dc.contributor.author | Gawande, Atul A. | |
dc.contributor.author | Block, Susan D. | |
dc.date | 2022-08-11T08:10:35.000 | |
dc.date.accessioned | 2022-08-23T17:13:28Z | |
dc.date.available | 2022-08-23T17:13:28Z | |
dc.date.issued | 2018-04-16 | |
dc.date.submitted | 2018-06-27 | |
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.issn | 1557-7740 (Linking) | |
dc.identifier.doi | 10.1089/jpm.2017.0374 | |
dc.identifier.pmid | 29658817 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/46736 | |
dc.description.abstract | 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. 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.iso | en_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.url | https://doi.org/10.1089/jpm.2017.0374 | |
dc.subject | advance care planning | |
dc.subject | advance directive adherence | |
dc.subject | cross-cultural comparison | |
dc.subject | Epidemiology | |
dc.subject | Health Services Administration | |
dc.subject | Health Services Research | |
dc.subject | Palliative Care | |
dc.subject | Race and Ethnicity | |
dc.title | Racial and Ethnic Differences in Advance Care Planning: Results of a Statewide Population-Based Survey | |
dc.type | Journal Article | |
dc.source.journaltitle | Journal of palliative medicine | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/qhs_pp/1195 | |
dc.identifier.contextkey | 12399213 | |
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.submissionpath | qhs_pp/1195 | |
dc.contributor.department | Department of Quantitative Health Sciences |