Medical care
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Comparative Study
Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample.
Racial and ethnic disparities in health care have been well documented, but poorly explained. ⋯ Among insured nonelderly adults, there are appreciable disparities in health-care use by race and Hispanic ethnicity. Ethnic disparities in care are largely explained by differences in English fluency, but racial disparities in care are not explained by commonly used access factors.
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Availability of options other than aggressive medical treatment for persons with life-limiting illnesses has provided hospitals an opportunity to adopt formalized end-of-life care services. ⋯ Given the attention paid by both the general public and health professionals to pain relief and providing appropriate care to dying persons, such services are slow to be institutionalized in the hospital setting. The authors' findings suggest strategies for research and policy.
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Patients communicate their desires and expectations largely by making requests. However, the antecedents and consequences of request fulfillment have received limited attention. ⋯ Request fulfillment affects patient and physician satisfaction and perceptions of health outcomes. New approaches that efficiently recognize and respond to patient requests are needed.
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Editorial Comment
In-hospital end-of-life services: is the cup 2/3 empty or 1/3 full?