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Racial and ethnic differences in advance care planning : results of a statewide population-based survey
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Background: Few studies have focused on racial and ethnic differences in advance care planning other than advance directives among population-based samples of adults across the lifespan.
Methods: Using data from a statewide random-digit dial telephone survey of adults 18 years or older (n = 1851), we investigated racial and ethnic differences in (1) designation of a healthcare agent (HCA); and (2) communication of goals, values, and preferences for end-of-life care with healthcare providers, a HCA, or other family members and friends.
Results: Less than half (44%, 95% confidence interval [CI] = 41.3%–47.0%) of all participants had named a HCA. In multivariable analyses, participants who identified as Hispanic (adjusted odds ratio [aOR] = 0.4, 95% CI = 0.2–0.7) or non-Hispanic other (aOR = 0.6, 95% CI = 0.4–0.9) were less likely than non-Hispanic whites to have named a HCA. Only 14.5% (95% CI = 12.6%–16.5%) of all participants had ever had a conversation with a healthcare provider about their end-of-life care wishes, with no differences by race/ethnicity. Over half (53.9%, 95% CI = 51.0%–56.8%) of all participants reported having had conversations with someone other than a healthcare provider about their end-of-life wishes. In multivariable analyses, non-Hispanic whites were more likely than Hispanics (aOR = 0.5, 95% CI = 0.3–0.7), black/African Americans (aOR = 0.5, 95% CI = 0.3–0.9), and non-Hispanic others (aOR = 0.7, 95% CI = 0.5–1.0) to report having had such conversations.
Conclusions: Racial and ethnic minorities may be disadvantaged in the quality of care they receive if they have a serious illness and are unable to make decisions for themselves because most have not talked to anyone about their goals, values, or preferences for care.
http://dx.doi.org/10.1089/jpm.2017.0374
Voir la revue «JOURNAL OF PALLIATIVE MEDICINE, 21»
Autres numéros de la revue «JOURNAL OF PALLIATIVE MEDICINE»
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