Higher Admittance to Specialized Palliative Care for Patients with High Education and Income: A Nation-Wide Register-Based Study

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Mathilde Adsersen, University of Copenhagen
  • ,
  • Lau Caspar Thygesen, University of Southern Denmark
  • ,
  • Mette Asbjoern Neergaard
  • Per Sjøgren, University of Copenhagen
  • ,
  • Lise Mondrup, Sydvestjysk Hospital
  • ,
  • Jette Soegaard Nissen, Hospice Fyn
  • ,
  • Lars Michael Clausen, Pediatric Department, Naestved Hospital, Naestved
  • ,
  • Mogens Groenvold, University of Copenhagen

Background: While associations between socioeconomic position, that is, income and education and admittance to specialized palliative care (SPC) have been investigated previously, no prior national studies have examined admittance to all types of SPC, that is, hospital-based palliative care team/units and hospice. Aim: To investigate whether cancer patients' education and income were associated with admittance to SPC (hospital-based palliative care team/unit, hospice). Design: Data sources were several nation-wide registers. The association between SPC and education and income, respectively, was investigated using logistic regression analyses. Setting/Participants: Patients dying from cancer in Denmark 2010-12 ( n  = 41,741). Results: In the study population, 45% had lower secondary school, and 6% had an academic education. Patients with an academic education were more often admitted to SPC than those having lower secondary school (odds ratio [OR] = 1.69; 95% confidence interval [CI]: 1.51-1.89). Patients in the highest income quartile (Q4) were more often admitted than those in the lowest income quartile (Q1) (OR = 1.46; 95% CI: 1.37-1.56). This association was stronger for hospice (OR = 1.67 (95% CI: 1.54-1.81)) than for admittance to hospital-based palliative care team/unit (OR = 1.23 (95% CI: 1.14-1.31)). Compared with patients who had lower secondary school and the lowest income, the OR of admittance to SPC among the most affluent academics was 1.96 (95% CI: 1.71-2.25). Conclusion: This nationwide study indicates that admittance to SPC was clearly associated with education and income. We believe that the associations indicate inequity. Initiatives to improve access for patients with low education or income should be established.

Original languageEnglish
JournalJournal of Palliative Medicine
Volume26
Issue1
Pages (from-to)57-66
Number of pages10
ISSN1096-6218
DOIs
Publication statusPublished - Jan 2023

    Research areas

  • Hospice Care, Hospice and Palliative Care Nursing, Hospices, Humans, Neoplasms/therapy, Palliative Care

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