2012
DOI: 10.1080/01621424.2011.641922
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Racial/Ethnic Minority Access to End-of-Life Care: A Conceptual Framework

Abstract: Minority underutilization of hospice care has been well-documented; however, explanations addressing disparities have failed to examine the scope of factors in operation. Drawing from previous health care access models, a framework is proposed in which access to end-of-life care results from an interaction between patient-level, system-level, and societal-level barriers with provider-level mediators. The proposed framework introduces an innovative mediating factor missing in previous models, provider personal … Show more

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Cited by 14 publications
(53 citation statements)
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“…These disparities are likely indicative of variations in physician knowledge of, familiarity with, and perspectives regarding hospice. Consistent with this, there are well-documented, widespread variations in patients' perceptions and usage of hospice, 19,[49][50][51][52][53][54] with recent work also identifying such disparities among physicians. 55,56 Given the widely accepted benefits of hospice, our findings suggest significant discrepancies among physicians in providing quality end-of-life care to patients with advanced cancer.…”
Section: Discussionmentioning
confidence: 69%
“…These disparities are likely indicative of variations in physician knowledge of, familiarity with, and perspectives regarding hospice. Consistent with this, there are well-documented, widespread variations in patients' perceptions and usage of hospice, 19,[49][50][51][52][53][54] with recent work also identifying such disparities among physicians. 55,56 Given the widely accepted benefits of hospice, our findings suggest significant discrepancies among physicians in providing quality end-of-life care to patients with advanced cancer.…”
Section: Discussionmentioning
confidence: 69%
“…28 The development of this framework was built on a conceptual model of factors influencing death at home by Gomes and Higginson 12 and relevant health service models that include the impact of a service component on either end-of-life care outcomes or service access/ utilisation. 14,[29][30][31][32][33][34] The service components that could potentially influence where people die and their organisation were identified from and guided by these models.…”
Section: Conceptual Frameworkmentioning
confidence: 99%
“…Thus, culture influences the use of healthcare at the end-of-life. Issues influenced by culture that create barriers to palliative care include language and communication barriers, religion and spirituality, responses to inequities in care, and family involvement with decision making (Kagawa-Singer & Blackhall, 2001; Laguna, Enguídanos, Siciliano, & Coulourides-Kogan, 2012; Siriwardena & Clark, 2004). Several factors contributing to limitations in language differences include limited use of medical interpreters and paucity of patient-centered and culturally aligned literature regarding hospice or palliative care in other languages.…”
Section: Introductionmentioning
confidence: 99%