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While enrollment in hospice is soaring, nonwhite Medicare beneficiaries with heart failure are 20% less likely to use hospice, a new study finds.

“When considering end-of-life care options, it is important to consider hospice services at home, in nursing homes or in hospice facilities,” lead investigator, Kathleen T. Unroe, M.D. said. “Our findings highlight that there is a significant difference between how white patients and nonwhite patients and their families utilize hospice services.”

In analyzing records of 219,275 Medicare beneficiaries with heart failure, investigators from the Regenstrief Institute found heart disease was the third most common diagnosis of those in hospice. While nonwhite patients were more likely to disenroll from hospice, even those in hospice were more likely to land in the emergency room, be hospitalized and be admitted to intensive care.

The study was published in the June issue of the American Heart Journal.