Table 3.
Relationship Between Hospice Characteristics, Area Health Care Resources, Decedent Demographics and Proportion of African-American and White Medicare Beneficiaries Who Enrolled in Hospice in Hospice Service Area
| % African-American Decedents Served a | %White Decedents Served a | |
|---|---|---|
|
| ||
| Hospice Characteristics | ||
|
P-value Mean (SD) |
||
|
| ||
| Ownership | <0.0001 | <0.0001 |
| Nonprofit | 0.22 (0.13) | 0.27 (0.14) |
| For-profit | 0.06 (0.06) | 0.07 (0.07) |
|
| ||
| Agency Type | 0.20 | 0.33 |
| Free-Standing | 0.20 (0.15) | 0.25 (0.17) |
| Home-Health Affiliated | 0.12 (0.10) | 0.16 (0.13) |
| Hospital Affiliated | 0.18 (0.11) | 0.23 (0.13) |
|
| ||
| Budget | <0.0001 | 0.0003 |
| < $1,000,000 | 0.05 (0.05) | 0.08 (0.08) |
| $1,000,000 to 3,999,999 | 0.13 (0.07) | 0.18 (0.12) |
| $≥ 4,000,000 | 0.24 (0.14) | 0.29 (0.16) |
|
| ||
| Average Daily Census | 0.0003 | 0.0015 |
| ≤ 50 | 0.09 (0.07) | 0.13 (0.09) |
| 51 to 100 | 0.21 (0.11) | 0.27 (0.16) |
| >100 | 0.25 (0.15) | 0.28 (0.16) |
|
| ||
| Healthcare Resources in Hospice Service Area | ||
| Correlation r (P-value) | ||
|
| ||
| MD/population ≥ 65 yrs | −0.267 (0.04) | −0.22 (0.09) |
|
| ||
| % generalists b | 0.37 (0.003) | 0.33 (0.01) |
|
| ||
| Hospital beds/population ≥ 65 yrs | −0.13 (0.31) | −0.15 (0.24) |
|
| ||
| Skilled nursing facility beds/population ≥ 65 yrs | 0.20 (0.12) | 0.25 (0.05) |
|
| ||
| Nursing home beds/population ≥ 65 yrs | 0.09 (0.49) | 0.08 (0.53) |
|
| ||
| Rurality | 0.02 (0.88) | 0.13 (0.31) |
|
| ||
| Market Competition Herfindahl Hirschman Index (HHI) c | 0.82 (<0.0001) | 0.88 (<0.0001) |
|
| ||
| Decedent Demographics in Hospice Service area | ||
| Correlation r (P-value) | ||
|
| ||
| Age | 0.09 (0.51) | 0.12 (0.37) |
|
| ||
| % female | 0.07 (0.60) | 0.16 (0.21) |
|
| ||
| % cancer deaths | −0.10 (0.51) | −0.24 (0.10) |
% served refers to % of decedents served by hospice in the hospice service area (HSA) and equals the total number of decedents (African American or White) who received care from the hospice provider in the hospice service area (HSA) divided by the total number of decedents (African-American or White) in a HSA. We defined the HSA for each hospice as any county or counties where at least 20% of the hospice’s patients resided.
% generalists refers to percentage of physicians in the hospice service area who were generalists (medical doctors or doctors of osteopathic medicine whose major professional specialty was General or Family Practice).
Herfindahl Hirschman Index (HHI): This is a measure of market concentration or competition from other hospices in the service area. A higher HHI indicates a less competitive market.