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- Publisher Website: 10.1177/0269216320947964
- Scopus: eid_2-s2.0-85089137902
- PMID: 32772809
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Article: Persistent socioeconomic inequalities in location of death and receipt of palliative care: A population-based cohort study
Title | Persistent socioeconomic inequalities in location of death and receipt of palliative care: A population-based cohort study |
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Authors | |
Keywords | Death healthcare disparities Ontario/epidemiology palliative care socioeconomic factors |
Issue Date | 2020 |
Citation | Palliative Medicine, 2020, v. 34, n. 10, p. 1393-1401 How to Cite? |
Abstract | Background: Providing equitable care to patients in need across the life course is a priority for many healthcare systems. Aim: To estimate socioeconomic inequality trends in the proportions of decedents that died in the community and that received palliative care within 30 days of death (including home visits and specialist/generalist physician encounters). Design: Cohort study based on health administrative data. Socioeconomic position was measured by area-level material deprivation. Inequality gaps were quantified annually and longitudinally using the slope index of inequality (absolute gap) and relative index of inequality (relative gap). Setting/Participants: A total of 729,290 decedents aged ⩾18 years in Ontario, Canada from 2009 to 2016. Results: In 2016, the modelled absolute gap (corresponding 95% confidence interval) between the most- and least-deprived neighbourhoods in community deaths was 4.0% (2.9–5.1%), which was 8.6% (6.2–10.9%) of the overall mean (46.6%). Relative to 2009, these inequalities declined modestly. Inequalities in 2016 were evident for palliative home visits (6.8% (5.8–7.8%) absolute gap, 26.3% (22.5–30.0%) relative gap) and for physician encounters (6.8% (5.7–7.9%) absolute gap, 13.2% (11.0–15.3%) relative gap), and widened from 2009 for physician encounters only on the absolute scale. Inequalities varied considerably across disease trajectories (organ failure, terminal illness, frailty, and sudden death). Conclusion: Key measures of end-of-life care are not achieved equally across socioeconomic groups. These data can be used to inform policy strategies to improve delivery of palliative and end-of-life services. |
Persistent Identifier | http://hdl.handle.net/10722/346879 |
ISSN | 2023 Impact Factor: 3.6 2023 SCImago Journal Rankings: 1.310 |
DC Field | Value | Language |
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dc.contributor.author | Mondor, Luke | - |
dc.contributor.author | Wodchis, Walter P. | - |
dc.contributor.author | Tanuseputro, Peter | - |
dc.date.accessioned | 2024-09-17T04:13:53Z | - |
dc.date.available | 2024-09-17T04:13:53Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Palliative Medicine, 2020, v. 34, n. 10, p. 1393-1401 | - |
dc.identifier.issn | 0269-2163 | - |
dc.identifier.uri | http://hdl.handle.net/10722/346879 | - |
dc.description.abstract | Background: Providing equitable care to patients in need across the life course is a priority for many healthcare systems. Aim: To estimate socioeconomic inequality trends in the proportions of decedents that died in the community and that received palliative care within 30 days of death (including home visits and specialist/generalist physician encounters). Design: Cohort study based on health administrative data. Socioeconomic position was measured by area-level material deprivation. Inequality gaps were quantified annually and longitudinally using the slope index of inequality (absolute gap) and relative index of inequality (relative gap). Setting/Participants: A total of 729,290 decedents aged ⩾18 years in Ontario, Canada from 2009 to 2016. Results: In 2016, the modelled absolute gap (corresponding 95% confidence interval) between the most- and least-deprived neighbourhoods in community deaths was 4.0% (2.9–5.1%), which was 8.6% (6.2–10.9%) of the overall mean (46.6%). Relative to 2009, these inequalities declined modestly. Inequalities in 2016 were evident for palliative home visits (6.8% (5.8–7.8%) absolute gap, 26.3% (22.5–30.0%) relative gap) and for physician encounters (6.8% (5.7–7.9%) absolute gap, 13.2% (11.0–15.3%) relative gap), and widened from 2009 for physician encounters only on the absolute scale. Inequalities varied considerably across disease trajectories (organ failure, terminal illness, frailty, and sudden death). Conclusion: Key measures of end-of-life care are not achieved equally across socioeconomic groups. These data can be used to inform policy strategies to improve delivery of palliative and end-of-life services. | - |
dc.language | eng | - |
dc.relation.ispartof | Palliative Medicine | - |
dc.subject | Death | - |
dc.subject | healthcare disparities | - |
dc.subject | Ontario/epidemiology | - |
dc.subject | palliative care | - |
dc.subject | socioeconomic factors | - |
dc.title | Persistent socioeconomic inequalities in location of death and receipt of palliative care: A population-based cohort study | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1177/0269216320947964 | - |
dc.identifier.pmid | 32772809 | - |
dc.identifier.scopus | eid_2-s2.0-85089137902 | - |
dc.identifier.volume | 34 | - |
dc.identifier.issue | 10 | - |
dc.identifier.spage | 1393 | - |
dc.identifier.epage | 1401 | - |
dc.identifier.eissn | 1477-030X | - |