Study shows hospice accessible

Proximity to service not a barrier to use

Researchers at Mount Sinai School of Medicine have found that 98% of the U.S. population lives in communities within 60 minutes of a hospice provider, which suggests that disparities in use of hospice are not likely due to a lack of access to a hospice provider.1

The research team studied data from the 2008 Medicare Provider of Services data, U.S. Census data, and geographic mapping software. Census tract characteristics evaluated included population per mile, population over the age of 65, median household per capita income, percentage over the age of 18 with less than a high school education, black population percentage, and census region. The team determined that 98% of the U.S. population lives within 60 minutes of a hospice, and 88% live within 30 minutes from one.

The average number of minutes between a community center and a hospice was 15 minutes. The number of minutes to the nearest hospice was lower in communities with several characteristics, including: higher population per square mile, higher median household income, lower percentage with less than a high school education, and a higher black population percentage. Communities with higher percentages of the population who are black are more likely to have geographic access to hospice, but previous research has shown that people who are black are less likely to use hospice compared with people who are white.

Authors suggest that the growth in the number of hospices since 2000 has improved access to hospice care as the closest hospice for about one-third of the population, in both rural and urban areas, is a relatively new hospice, certified by Medicare since 2000. However, the authors point out that more research is needed to determine why more patients and their families are not under the care of a hospice at the end of life, including hospice admission criteria and patient financial and cultural factors that might present barriers to hospice use.


1. Carlson MD, Bradley EH, Du Q, et al. Geographic access to hospice in the United States. J Palliat Med 2010; 13:1331-1338.