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Research Letter
December 2016

Low Completion and Disparities in Advance Care Planning Activities Among Older Medicare Beneficiaries

Author Affiliations
  • 1Division of Geriatrics, University of California, San Francisco
  • 2San Francisco Veterans Affairs Medical Center, San Francisco, California
  • 3Center for Healthcare Outcomes and Policy at the University of Michigan, Ann Arbor
JAMA Intern Med. 2016;176(12):1872-1875. doi:10.1001/jamainternmed.2016.6751

Advance care planning (ACP) is an iterative process that includes discussions about preferences for end-of-life (EOL) care, completion of advance directives (AD), and designation of a surrogate decision maker in a durable power of attorney for health care (DPOA).1,2 Engagement in ACP has increased over time.3 However, the rising tide of ACP may not have lifted all boats equally. Minorities, those with lower levels of educational attainment, and the poor may not have benefited from rising rates of ACP to the same extent that white, highly educated, affluent individuals have. Rates of ACP by older Latinos in particular are unknown. Further, we do not know if ACP uptake is greater among those in worse health and with poorer prognoses.

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