TY - JOUR
T1 - Association of Hospice Agency Location and Neighborhood Socioeconomic Disadvantage in the U.S.
AU - Osakwe, Zainab Toteh
AU - Calixte, Rose
AU - Peterson, Mandi Leigh
AU - Young, Sean G.
AU - Ikhapoh, Izuagie
AU - Pierre, Kaydeen
AU - McIntosh, Jennifer T.
AU - Senteio, Charles
AU - Girardin, Jean Louis
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/3
Y1 - 2024/3
N2 - Background: Despite the growing increase in the utilization of hospice in the U.S, disparities exist in the utilization of hospice. Accumulating evidence has shown that neighborhood characteristics have an impact on availability of hospice agencies. Objective: To assess the association between neighborhood social vulnerability and hospice agency availability. Methods: Using the Medicare Post-Acute Care and Hospice Provider Utilization and Payment Public Use Files (PAC PUF) for 2019. Hospice agency addresses were geocoded to the census tract level. Multivariable Poisson regression models were used to assess the association between socioeconomic status SVI theme and hospice agency availability adjusting for number of home health agencies, primary care health profession shortage, per cent Black, and Percent Hispanic at the census tract level and rurality. Results: The socioeconomic status SVI subtheme was associated with decreased likelihood of hospice agency availability (adjusted IRR (aIRR),.56; 95% CI,.50-.63; P <.001). Predominantly Black, and predominantly Hispanic neighborhoods had lower rates of hospice agency availability (aIRR,.48; 95% CI,.39-.59; P <.001 and aIRR,.29; 95% CI,.24-.36; P <.001), respectively. Conclusion: Neighborhood socioeconomic disadvantage was associated with lower availability of hospice agencies. Policies aimed at increasing access to hospice should be cognizant of neighborhood socioeconomic disadvantage.
AB - Background: Despite the growing increase in the utilization of hospice in the U.S, disparities exist in the utilization of hospice. Accumulating evidence has shown that neighborhood characteristics have an impact on availability of hospice agencies. Objective: To assess the association between neighborhood social vulnerability and hospice agency availability. Methods: Using the Medicare Post-Acute Care and Hospice Provider Utilization and Payment Public Use Files (PAC PUF) for 2019. Hospice agency addresses were geocoded to the census tract level. Multivariable Poisson regression models were used to assess the association between socioeconomic status SVI theme and hospice agency availability adjusting for number of home health agencies, primary care health profession shortage, per cent Black, and Percent Hispanic at the census tract level and rurality. Results: The socioeconomic status SVI subtheme was associated with decreased likelihood of hospice agency availability (adjusted IRR (aIRR),.56; 95% CI,.50-.63; P <.001). Predominantly Black, and predominantly Hispanic neighborhoods had lower rates of hospice agency availability (aIRR,.48; 95% CI,.39-.59; P <.001 and aIRR,.29; 95% CI,.24-.36; P <.001), respectively. Conclusion: Neighborhood socioeconomic disadvantage was associated with lower availability of hospice agencies. Policies aimed at increasing access to hospice should be cognizant of neighborhood socioeconomic disadvantage.
KW - census tract
KW - disparities
KW - geographic variation
KW - hospice
KW - medicare
KW - social vulnerability index
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U2 - 10.1177/10499091231195319
DO - 10.1177/10499091231195319
M3 - Article
C2 - 37644697
AN - SCOPUS:85170534888
SN - 1049-9091
VL - 41
SP - 309
EP - 317
JO - American Journal of Hospice and Palliative Medicine
JF - American Journal of Hospice and Palliative Medicine
IS - 3
ER -