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美国临终关怀中的种族和民族差异:来自健康与退休研究(HRS)的证据。

Racial and ethnic differences in end-of-life care in the United States: Evidence from the Health and Retirement Study (HRS).

作者信息

Orlovic Martina, Smith Katharine, Mossialos Elias

机构信息

Department of Surgery and Cancer, Faculty of Medicine, Institute of Global Health Innovation, 10th Floor, QEQM Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom.

Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, South Wharf Road, London W2 1NY, United Kingdom.

出版信息

SSM Popul Health. 2018 Nov 30;7:100331. doi: 10.1016/j.ssmph.2018.100331. eCollection 2019 Apr.

Abstract

Population ageing poses considerable challenges to the provision of quality end-of-life care. The population of the United States is increasingly diverse, making it imperative to design culturally sensitive end-of-life care interventions. We examined participants of the Health and Retirement Study, who died between 2002 and 2014, to examine racial and ethnic differences in end-of-life care utilization and end-of-life planning in the United States. Our study reveals significant disparities in end-of-life care and planning among studied groups. Findings reveal that racial and ethnic minorities are more likely to die in hospital and less likely to engage in end-of-life planning activities. The observed disparities are still significant but have been narrowing between 2002 and 2014. Efforts to reduce these differences should target both medical professionals and diverse communities to ensure that improved models of care acknowledge heterogeneous values and needs of a culturally diverse US population.

摘要

人口老龄化对提供高质量的临终关怀构成了巨大挑战。美国人口日益多样化,因此设计对文化敏感的临终关怀干预措施势在必行。我们研究了2002年至2014年间去世的健康与退休研究的参与者,以考察美国临终关怀利用和临终规划方面的种族和族裔差异。我们的研究揭示了研究群体在临终关怀和规划方面存在显著差异。研究结果表明,少数种族和族裔群体更有可能在医院死亡,并且参与临终规划活动的可能性较小。观察到的差异仍然很大,但在2002年至2014年间一直在缩小。减少这些差异的努力应针对医疗专业人员和不同社区,以确保改进的护理模式承认文化多元的美国人口的异质价值观和需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04a1/6305800/f48fe6c1c23e/gr1.jpg

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