Abstract
The Behavioral Model of Hospice Use, a newly developed model for the study of hospice utilization, was used to guide this preliminary study examining factors associated with hospice use after referral. Information on 614 referred hospice patients was extracted from a home hospice database, including individual patient demographics, hospice enrollment status, and reported reasons for not enrolling in hospice. Race was the only predictor of enrollment in hospice based upon results from the backward regression model (P = .010). Whites were more likely to enroll than nonwhites. Nonwhite patients were more likely to not use hospice because of prognosis-driven reasons than whites after adjusting for gender, age, diagnosis, insurance, and marital status (P = .044). The findings indicated that racial and ethnic disparities in hospice use may be related to institutional rules and regulations, rather than patient preference, and the racial/ethnic disparities in health and healthcare services.