A Review of Barriers to Utilization of the Medicare Hospice Benefits in Urban Populations and Strategies for Enhanced Access

Disparities in access to health care extend to end-of-life care. Lack of access to hospice mirrors lack of access to health maintenance and primary care. Patients who are served by hospice nationally are disproportionately white and likely to reside in economically stable communities. In many urban...

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Bibliographic Details
Published in:Journal of urban health 2008-03, Vol.85 (2), p.281-290
Main Authors: O’Mahony, Sean, McHenry, Janet, Snow, Daniel, Cassin, Carolyn, Schumacher, Donald, Selwyn, Peter A.
Format: Article
Language:English
Subjects:
Epidemiology
Health care access
Health Informatics
Health Services Accessibility - economics
Health services utilization
Healthcare Disparities - economics
Hospice care
Hospice Care - economics
Hospice Care - utilization
Humans
Inequality
Low income areas
Medicare
Medicine
Medicine & Public Health
Minority Groups
Palliative care
Palliative Care - economics
Palliative Care - utilization
Poverty
Public Health
United States
Urban areas
Urban Health
Urban populations
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Summary:Disparities in access to health care extend to end-of-life care. Lack of access to hospice mirrors lack of access to health maintenance and primary care. Patients who are served by hospice nationally are disproportionately white and likely to reside in economically stable communities. In many urban low-income communities, less than 5% of decedents receive hospice care in the last 6 months of life. This review focuses on barriers to palliative care and hospice in urban, predominantly low-income communities, including cultural and reimbursement factors and the paucity of hospice providers, outreach projects, and in-patient hospice beds in urban communities. This review will also address some strategies that are being implemented by hospices locally and nationally to overcome demographic barriers to hospice care.
ISSN:1099-3460
1468-2869
DOI:10.1007/s11524-008-9258-y