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OBJECTIVES: To examine racial and ethnic variation in use of hospice and high‐intensity care in patients with terminal illness.

DESIGN: Retrospective, secondary data analysis.

SETTING: Surveillance, Epidemiology, and End Results‐Medicare Database from 1992 to 1999 with follow‐up data until December 31, 2001.

PARTICIPANTS: Forty thousand nine hundred sixty non‐Hispanic white, non‐Hispanic black, Asian, and Hispanic fee‐for‐service Medicare beneficiaries aged 65 and older with advanced‐stage lung, colorectal, breast, and prostate cancer.

MEASURMENTS: Hospice use and indicators of high‐intensity care at the end of life.

RESULTS: Whereas 42.0% of elderly white patients with advanced cancer enrolled in hospice, enrollment was lower for black (36.9%), Asian (32.2%), and Hispanic (37.7%) patients. Differences between white and Hispanic patients disappeared after adjustment for clinical …