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Health Disparities in Hospice-Home Health Transitions Among Hispanic or Latino Older Adults with Co-occurring Dementia and Cardiovascular Disease

Purpose: Hispanic or Latino older adults in the US are 1.5 times more likely to have Alzheimer’s and related dementias (ADRD) than white older adults. Nearly one third of all skilled home health (HH) patients and nearly one half of hospice patients have ADRD diagnoses. In ADRD’s long trajectory of decline, patient care transitions bring risks for poor outcomes. Minoritized patients are at high risk for live discharge from hospice, but little is known about those who transition from hospice to skilled HH, the fastest-growing long-term care setting in the US.
Aims: to determine demographic and diagnostic variables among patients with ADRD who transition from hospice to skilled HH.
Methods: We used Medicare claims data and descriptive statistics including Chi-Square to determine demographic differences in frequency of care transitions from hospice to skilled HH for (a) older adults with ADRD and (b) older adults with co-occurring ADRD and cardiovascular disease (CVD).
Results: In N = 272,323 hospice episodes, we found that Hispanic or Latino older adults with co-occurring ADRD and CVD had significantly higher rates of care transitions from hospice to skilled HH (P=0.037) than other racial and ethnic groups with both diagnoses.
Conclusions: This is the first study to our knowledge that provides evidence on disparities in care transitions from hospice to skilled HH for Hispanic or Latino older adults with ADRD and CVD. Multiple factors may impact this result. Implications include policy change and greater coordination across systems of care, with specific attention to health equity.

Identiferoai:union.ndltd.org:ETSU/oai:dc.etsu.edu:es-conf-1128
Date11 April 2024
CreatorsBigger, Sharon, Grubbs, Kathy, Cao, Yan, Towsley, Gail L
PublisherDigital Commons @ East Tennessee State University
Source SetsEast Tennessee State University
Detected LanguageEnglish
Typetext
SourceEpsilon Sigma at-Large Research Conference

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