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Hispanic access to hospice services in a predominantly Hispanic community

University of Texas College of Health Sciences, School of Nursing, El Paso, Texas

Kathryn Horn, MD

Department of Family Practice, Texas Tech University Health Sciences Center, El Paso, Texas

Julia Bader, PhD

Statistical Consulting Laboratory, University of Texas, El Paso, Texas

Although the largest minority population in the United States, Hispanics are under-represented in hospice at the national level. The study purpose was to document Hispanic access to hospice services in an environment where Hispanics are a majority population. The framework for the study was Aday and Anderson’s model for access to medical care. In this framework, access is not defined as availability of services and resources, but whether services are actually used by the people who need them. We completed retrospective chart reviews of 500 Medicare beneficiaries who died in four hospices. Study variables were decedent characteristics and access to hospice and hospice disciplines. Results showed that Hispanics and whites differed on characteristics known to influence access to health services, e.g., preferred language and type of caregiver. Although the proportion of Hispanic elders dying in hospice was less than the proportion living in the community, the proportions of Hispanic elders who died in the community or died in their homes were not different from the proportion that died in hospice. When access to hospice disciplines was compared between Hispanic and white decedents, the results showed one difference—more whites than Hispanics had access to volunteer services. Overall, the study showed that Hispanics were not underrepresented in hospice, and they had equal access to hospice disciplines. These findings differ from national data and may be associated with Hispanics being the majority population in the community. To learn how population dominance influences minority access to services, Hispanic access to hospice could be studied in locales with varying proportions of Hispanics in the population.

Key Words: end-of-life care • hospice • healthcare access • Hispanic • diversity

American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 1, 9-16 (2006)
DOI: 10.1177/104990910602300103


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