Abstract
Disparities in Hospice Utilization and End-of-Life Outcomes Among Hispanic Medicare Beneficiaries with Alzheimer’s Disease and Related Dementias.
Greg N. Orewa, PhD, Assistant Professor, Department of Public Health, UTSA
Although disproportionately affected by ADRD, Hispanics they have lower rates of hospice and end-of-life (EOL) program utilization than non-Hispanic whites (NHW).(1-5) Relatively little research has explored the social determinants of said disparities, with community-level factors likely of particular relevance. Aim 1. To assess the extent to which community/social determinants of health explain disparities in hospice utilization among Hispanic Medicare beneficiaries with ADRD compared to NHW counterparts. Aim 2: To identify how hospice utilization influences disparities in EOL outcomes among Hispanics and NHWs with AD/ADRD. This project combines data from Medicare claims (MEDPAR, MBSF-BASE, MBSF-CC), Area Health Resources Files, and Agency for Healthcare Research and Quality Social Determinants of Health. We will measure hospice utilization as enrollment and total hospice days; and EOL outcomes as emergency department visits, hospitalizations, in-hospital deaths. Analyses will examine the impact of community-level barriers on Hispanic/NHW disparities in all outcomes. The project advances understanding of the consequences of ADRD for Hispanics, a central CAPAS theme. It will also allow Dr. Orewa to expand his expertise in long-term and quality care, more centrally adding an Hispanic/ADRD research agenda, and deepening collaborations with diverse scholars at other institutions. In Y2, he will apply for NIA funding (e.g., PAR-23-227). Insights from the study will strengthen the proposal’s innovation, methodological rigor, and policy relevance.