Gaps in hospice accessibility

Education, age, income are determinants

More than a third of Americans now die under the care of a hospice service. But a University of Michigan study reveals major gaps in the availability of hospice care across the country — gaps that the researchers attribute directly to the way hospice care is currently funded in America.

Most strikingly, the study finds that communities with lower average incomes and education levels, and areas with large concentrations of elderly people, are far less likely to be served by a hospice than communities with wealthier, more educated, and younger populations.

For example, the more households with incomes over $100,000, or residents who held at least a high school diploma, the better the access to hospice. But surprisingly, the higher the percentage of older residents, the lower the availability of hospice.

According to the researchers, relying on the ability of patients or their families to pay for care and services that aren't covered by Medicare or other insurance — and counting on charity and volunteers to make ends meet — means that hospices are most likely to flourish in areas where incomes are highest.