National Healthcare Quality and Disparities Report
- Hospice care is generally delivered at the end of life to patients with a terminal illness or condition who want palliative medical care.
- Hospice care also includes practical, psychosocial, and spiritual support for the patient and family.
- The goal of end-of-life care is to achieve a “good death,” defined by the Institute of Medicine1 as:
...free from avoidable distress and suffering for patients, families, and caregivers; in general accord with the patients’ and families’ wishes; and reasonably consistent with clinical, cultural, and ethical standards (Field & Cassell, 1997).
Hospice Patients Who Received Care Consistent With Their Stated End-of-Life Wishes
Hospice patients who received care consistent with their stated end-of-life wishes, by age and ethnicity, 2008-2014
Left Chart:
| Age | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 |
|---|---|---|---|---|---|---|---|
| 18-44 | 89.3 | 93.4 | 94.3 | 90 | 93 | 91.8 | 92.2 |
| 45-64 | 93.1 | 93.3 | 93.4 | 93.2 | 93.2 | 93 | 93.2 |
| 65+ | 94.4 | 94.7 | 94.6 | 94.9 | 95 | 95.1 | 95.1 |
Right Chart:
| Ethnicity | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 |
|---|---|---|---|---|---|---|---|
| Total | 94.2 | 94.6 | 94.4 | 94.6 | 94.8 | 94.8 | 94.8 |
| White | 94.7 | 95.1 | 94.8 | 95.3 | 95.5 | 95.6 | 95.7 |
| Black | 87.8 | 89.2 | 90.3 | 89.4 | 89.7 | 89.9 | 89.6 |
| Hispanic | 88.8 | 89.9 | 89 | 88.7 | 89.5 | 88.7 | 90.5 |
Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care Survey, 2008-2014.
Note: White and Black are non-Hispanic. Hispanic includes all races.
- Overall Rate: In 2014, nearly all (94.8%) of hospice patients received care consistent with their stated end-of-life wishes.
- Trends:
- From 2008 to 2014, the percentage of hospice patients age 65 and over who received care consistent with their stated end-of-life wishes improved from 94.4% to 95.1%. There were no statistically significant changes for those age 18-44 and ages 45-64.
- From 2008 to 2014, the percentage of White hospice patients who received care consistent with their stated end-of-life wishes improved from 94.7% to 95.7%. There were no statistically significant changes among Blacks and Hispanics.
- Groups With Disparities:
- In 2014, hospice patients age 65 and over were significantly more likely than patients ages 18-44 to receive care consistent with their stated end-of-life wishes.
- In 2014, Black and Hispanic hospice patients were significantly less likely than White patients to receive care consistent with their stated end-of-life wishes.
Hospice Patients Who Received the Right Amount of Help for Feelings of Anxiety or Sadness
Hospice patients who received the right amount of help for feelings of anxiety or sadness, by ethnicity and race, 2008-2014
Left Chart:
| Ethnicity | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 |
|---|---|---|---|---|---|---|---|
| Total | 90.3 | 90.6 | 90.5 | 90.2 | 90.6 | 90.6 | 90.7 |
| Non-Hispanic White | 91.2 | 91.6 | 91.3 | 91.1 | 91.5 | 91.5 | 91.5 |
| Non-Hispanic Black | 86 | 85.5 | 85.9 | 86 | 84.6 | 85.2 | 85.9 |
| Hispanic | 85.3 | 85.7 | 86.8 | 85.7 | 87 | 85 | 87 |
Right Chart:
| Race | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 |
|---|---|---|---|---|---|---|---|
| AI/AN | 85 | 88.5 | 86.4 | 84.2 | 86.3 | 83.9 | 87.3 |
| API | 81.1 | 79.5 | 79.4 | 76.4 | 81.4 | 80.3 | 80.2 |
| Black | 86.1 | 85.1 | 85.8 | 86 | 84.3 | 85 | 85.4 |
| White | 91.1 | 91.5 | 91.3 | 91 | 91.4 | 91.4 | 91.4 |
Key: AI/AN = American Indian or Alaska Native; API = Asian or Pacific Islander.
Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care Survey, 2008-2014.
- Trends: From 2008 to 2014, there were no statistically significant changes by ethnicity or race in the percentage of hospice patients who received the right amount of help for feelings of anxiety or sadness.
- Groups With Disparities:
- In 2014, Hispanics and non-Hispanic Blacks were significantly less likely than non-Hispanic Whites to receive the right amount of help for feelings of anxiety or sadness.
- Also in 2014, Blacks, Asians and Other Pacific Islanders, and AI/ANs were significantly less likely than Whites to receive the right amount of help for feelings of anxiety or sadness.
References
Field M, Cassell C, eds. Approaching death: improving care at the end of life. Washington, DC: National Academy Press; 1997.
1. On March 15, 2016, the division of the National Academies of Sciences, Engineering, and Medicine that focuses on health and medicine was renamed the Health and Medicine Division instead of using the name Institute of Medicine.
