Minority Health Archive

Decreasing Use of Percutaneous Endoscopic Gastrostomy Tube Feeding for Veterans with Dementia - Racial Differences Remain

Braun, Ursula K and Raberneck, Linda and McCullough, Laurence B and Urbauer, Diana L and Wray, Nelda P and Lairson, David R and Beyth, Rebecca J (2005) Decreasing Use of Percutaneous Endoscopic Gastrostomy Tube Feeding for Veterans with Dementia - Racial Differences Remain. Journal of the American Geriatrics Society, 53 (2). pp. 242-248.

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OBJECTIVES: Percutaneous endoscopic gastrostomy (PEG) tube placement is a widely used method for long-term enteral feeding of demented patients unable to take sufficient food by mouth. National time trends in PEG tube use over the last decade have not been previously reported. The objective of this study was to determine whether use of PEG tubes for patients with dementia has changed over time and by race. DESIGN: Retrospective cohort study. SETTING: All Veterans Affairs hospitals. PARTICIPANTS: Using an administrative database of the Veterans Health Administration, all veterans with dementia and all veterans who received a PEG tube were identified between fiscal years 1990–2001. MEASUREMENTS: Proportion of PEG tube placement for dementia patients over time and by race. RESULTS: Four hundred thirteen thousand six hundred twenty-seven dementia patients aged 60 and older were identified, of whom 6,464 (1.6%) received a PEG tube. Use of PEG tubes for dementia patients increased during the first half of the decade but subsequently decreased almost to baseline after peaking in 1996 (1990: 1.2%, 1996: 1.8%, 2001: 1.3%). Time trends in the use of PEG tube feeding for dementia patients varied by race. Specifically, the relative risk for PEG tube placement in African-American dementia patients increased from 1.65 (95% confidence interval (CI)51.25–2.17, FY 1990) to 1.97 (95% CI51.62–2.4, FY 2001). CONCLUSION: Although the overall use of PEG tube feeding for dementia patients decreased over time, rates in use and changes in use over time varied significantly by race. Reasons for the differential use of this procedure should be explored.

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Item Type: Article
Additional Information: Access to full text is subject to the publisher's access restrictions.
Uncontrolled Keywords: PEG tube; dementia; time trends; end-of-life care
Subjects: Health > Health Equity
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Depositing User: Kismet Loftin-Bell
Date Deposited: 18 Oct 2005
Last Modified: 08 Jun 2011 12:36
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/288

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