Patterns of end-of-life care are known to vary by rurality and by minority status, and the availability of facilities such as hospice also vary with rurality. This study will examine the relationship between level of service use during the last six months of life and facility availability in county of residence (hospital, SNF, IRF, home health, hospice), as well as minority status of the beneficiary and whether the beneficiary is also eligible for Medicaid ("dual eligible").

Publications

• Differences in Medicare Service Use in the Last Six Months of Life Among Rural and Urban Dual – Eligible Beneficiaries
  Report
  Rural and Minority Health Research Center
  Date: 08/2017
  In this brief, we compare rural and urban dual-eligible beneficiaries to Medicare-only beneficiaries in their service utilization in the last six months of life. Within rural beneficiaries, we further explore differences associated with race/ethnicity.
• Differences in Medicare Utilization and Expenditures in the Last Six Months of Life Among Patients With and Without Alzheimer's Disease and Related Disorders
  Journal Article
  Rural and Minority Health Research Center
  Date: 10/2018
  The purpose of this study was to examine differences in utilization of inpatient services and Medicare expenditures (overall and by category) in the last six months of life for patients with, versus those without, a diagnosis of Alzheimer's disease and related disorders.
• Gender and Geographic Differences in Medicare Service Utilization During the Last Six Months of Life
  Journal Article
  Rural and Minority Health Research Center
  Date: 11/2017
  End-of-life issues are important for senior women, particularly rural women, who are more likely than their urban counterparts to live alone. The role of residence has yet to be investigated. The purpose of this study is to examine whether service utilization in the last six months of life differs across gender and rurality.
• Rural-Urban Differences in Costs of End-of-Life Care for the Last 6 Months of Life Among Patients With Breast, Lung, or Colorectal Cancer
  Journal Article
  Rural and Minority Health Research Center
  Date: 04/2018
  Our findings indicate that Medicare expenditures are lower for rural beneficiaries with each type of cancer than urban beneficiaries, even after adjusting for age, gender, race, dual eligibility, region, chronic conditions, and type of service utilization.
• Rural-Urban Differences in Medicare Service Use in the Last Six Months of Life
  Report
  Rural and Minority Health Research Center
  Date: 08/2017
  This brief focuses on the current status of healthcare use during the last six months of life among Medicare beneficiaries. We used data from a sample of Medicare beneficiary claims to assess whether service utilization differed between rural and urban decedents and across decedents of different race/ethnicity categories.
• Supply-Side Differences Only Modestly Associated With Inpatient Hospitalizations Among Medicare Beneficiaries in the Last Six Months of Life
  Journal Article
  Rural and Minority Health Research Center
  Date: 11/2017
  This study examined rural and urban Medicare beneficiaries and inpatient hospitalizations during their last six months of life. The study concluded that care at the end of life is much the same for rural and urban Medicare decedents.