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End-of-life planning depends on socio-economic and racial background: evidence from the US Health and Retirement Study (HRS)

Orlovic, Martina, Warraich, Haider, Wolf, Douglas and Mossialos, Elias ORCID: 0000-0001-8664-9297 (2021) End-of-life planning depends on socio-economic and racial background: evidence from the US Health and Retirement Study (HRS). Journal of Pain and Symptom Management, 62 (6). 1198 - 1206. ISSN 0885-3924

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Identification Number: 10.1016/j.jpainsymman.2021.05.018


Context: Americans express a strong preference for participating in decisions regarding their medical care, yet they are often unable to participate in decision-making regarding their end-of-life care. Objective: To examine determinants of end-of-life planning; including, the effect of an individual's ageing and dying process, health status and socio-economic and racial/ethnic background. Methods: US observational cohort study, using data from the Health and Retirement Study (1992 – 2014) including 37,494 individuals. Random-effects logistic regression analysis was used to examine the relationship between the presence of a living will and a range of individual time-varying characteristics, including time to death, and several time-invariant characteristics. Results: End-of-life planning depends on several patient characteristics and circumstances, with socio-economic and racial/ethnic background having the largest effects. The probability of having a living will rises sharply late in life, as we would expect, and is further modified by the patient's proximity to death. The dying process, exerts a stronger influence on end-of-life planning than does the aging. Conclusions: Understanding differences that increase end-of-life planning is important to incentivize patients’ participation. Advance planning should be encouraged and accessible to people of all ages as it is inevitable for the provision of patient-centered and cost-effective care.

Item Type: Article
Official URL:
Additional Information: © 2021 The Authors
Divisions: Health Policy
Subjects: R Medicine > R Medicine (General)
H Social Sciences > HT Communities. Classes. Races
H Social Sciences > HC Economic History and Conditions
Date Deposited: 04 Aug 2021 14:42
Last Modified: 21 Jun 2024 05:12

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