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Regional Practice Patterns and Racial/Ethnic Differences in Intensity of EndofLife Care

Objective: To examine whether regional practice patterns impact racial/ethnic differences in intensity of endoflife care for cancer decedents.

Data Sources: The linked Surveillance, Epidemiology, and End Results (SEER)Medicare database.

Study Design: We classified hospital referral regions (HRRs) based on mean 6month endoflife care expenditures, which represented regional practice patterns. Using hierarchical generalized linear models, we examined racial/ethnic differences in the intensity of endoflife care across levels of HRR expenditures.

Principal Findings: There was greater variation in intensity of endoflife care among Hispanics, Asians, and whites in highexpenditure HRRs than in lowexpenditure HRRs.

Conclusions: Local practice patterns may influence racial/ethnic differences in endoflife care.

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