Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
4198252 | Health Policy | 2010 | 7 Pages |
ObjectivesDetermine the prevalence of advance directives (ADs) in Maryland and identify the barriers and enablers to their adoption, in order to guide the formulation of state legislative policy.MethodsCross-sectional survey administered over the telephone to a representative age-stratified random sample of 1195 Maryland adults.ResultsApproximately 34% (n = 401) of Maryland adults reported having an AD. Older adults (65+ years) were more likely than younger adults (18–64 years) to have ADs (p < 0.001); the proportional difference between those with and without ADs diminished as age increased. Two times as many Whites than Blacks reported having ADs (43–23%; p < 0.001). Of those who had an AD, the primary motivations for creating one was a personal medical condition or a diagnosis to one's self or a family/friend (41%). Those without ADs identified lack of familiarity with them (27%), being too young or healthy to need one (14%), or uncertainty of the process for adopting one (11%) as reasons for not having one.ConclusionsBarriers to AD adoption appear amenable to policy interventions. Policies that seek to increase access and ensure ease of enrollment, combined with a targeted public health advocacy campaign, may help increase the prevalence of ADs.