Health and Disability

Quality of end-of life care depends a lot on timely referral to hospice care. Lack of hospice services often translates into less pain management. A growing body of research indicates that several types of cancer are referred to hospice very late. These late referrals indicate racial-ethnic, sociodemographic, socioeconomic, and age disparities. In a study of patients over 65 with ovarian cancer, a higher proportion of black women, women in the lowest income groups, and women receiving fee for service Medicare were never referred to hospice care. A substantial proportion of older women with ovarian cancer were referred to hospice care only when they were very near death.