Objective: To examine gender differences in the effects of preferences for care and socioeconomic status on location of death. Realizing that there are different influences on persons using institutional care, we concentrated on those who did not use nursing home in their last year of life. Methods: We analyzed data for decedents age 65 and over from the 1993 National Mortality Follow-back Survey. We used SUDAAN to estimate logistic regression models weighted to account for the complex sample design. Explanatory variables included age, race, ethnicity, region, functional status, number of medical visits, education, using Medicaid and using private insurance during the last year of life, having a living will, and use of hospice care. Hospital deaths included those in inpatient hospice. Results: Among men, those using hospice were more likely to die in the hospital bed (either acute care or hospice) than at home, but having a living will did not affect location of death. In contrast among women, hospice users were equally likely to die at home or in the hospital, but those with a living will were more likely to die at home. Because married people differ in their systems of support, we examined decedents separately by marital status and gender. Having a living will and using hospice care were associated with location of death only for married men and women. Among married women, those who used either private insurance or Medicaid were more likely to die in a hospital.
Learning Objectives: 1. Describe gender differences in the effects of preferences for care and SES on location of death. 2. Discuss the need to target interventions for end-of-life care to different social factors among married and unmarried men and women
Keywords: End-of-Life Care, Gender
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: The project was funded by the National Institute for Aging.