It's difficult to know why this disparity exists, but it could be because black and Hispanics are more likely to live in urban and rural areas where healthcare quality is usually poorer, said Rebecca Price, lead author of the study and a senior policy researcher at Rand Corp.
Price and her co-authors analyzed survey responses from nearly 300,000 hospice caregivers who completed the CMS' Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey from April 2015 to March 2016. The caregivers were from almost 2,500 hospices located in all 50 states.
Black and Hispanic patients were more likely to receive care from for-profit hospices than white patients. About 48% of black patients and 52% of Hispanic patients received care in a for-profit hospice versus 39% of white patients. The researchers note that for-profit hospices are more prone to lower quality care compared to not-for-profit hospices because they often use fewer skilled staff members and provide a narrower range of clinical services.
Caregivers of black and Hispanic patients said the emotional and religious support provided by hospice teams didn't meet their needs compared to caregivers of white patients. This was particularly true for caregivers of Hispanic patients, who were significantly more likely to say that they received "too much" emotional support.
Price said it's important for hospices to work to understand their patient populations and their unique cultural needs by offering language translators or working with faith-based organizations to accommodate a chaplain or pastor on-site.
"There are populations within hospices that might be best served by coordination with faith-based organizations," she said.
On a brighter note, the caregivers of black and Hispanic patients were more likely to say they received the appropriate amount of training needed versus caregivers of white patients. Price said it's unclear why this difference existed, but hospice training for caregivers is commonly regarded as better compared to other care settings.
An edited version of this story appears in Modern Healthcare's July 10 print edition.