Title

Knowledge and Preferences of End of Life Choices of Hispanics in South Florida: Informing Policy and Future Directions in End of Life Care

Location

Atlanta, Ga.

Publication Date / Copyright Date

11-5-2017

Abstract

With the aging of the population, access, quality and cost of end of life (EOL) care should take priority as an issue of public health importance as urged by APHA and the IOM. Ethnic and racial minority groups suffer disproportionately from higher rates of morbidity and mortality. Hispanics, however, utilize hospice/palliative care services less than other groups, resulting in unnecessary interventions, increased pain and suffering for individuals and families, as well as increasing costs for the health care system and payer. While cultural factors may account for the Hispanics’ underutilization of hospice and palliative care services at the end of life, there is also a current payment dichotomy between therapeutic and palliative care on one hand, and hospice care on another, which precludes the utilization of curative care while receiving hospice care for Medicare and Medicaid reimbursement. In 2014, the Affordable Health Care Act (ACA) authorized the creation of 3-year Medicare Care Choices Models demonstration programs where individuals could receive both curative and palliative care while in hospice. We conducted a study to investigate EOL care preferences among Hispanics in South Florida. Results of the study showed that close to 71% of Hispanics under 65 y/o who were participating in community health events, wanted a combination of choices for end of life care that would include curative treatment, comfort and supportive care. These findings seem to support the benefits of eliminating the payment dichotomy between palliative and hospice care to improve access and quality of EOL care choices for Hispanics.

Disciplines

Medicine and Health Sciences

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