Mathilde Adsersen1, Lau Caspar Thygesen2, Mette Asbjoern Neergaard3, Anders Bonde Jensen4, Per Sjøgren5, Anette Damkier6, Lars Michael Clausen7, Mogens Groenvold1,8. 1. 1 Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. 2. 2 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 3. 3 The Palliative Team, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. 4. 4 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. 5. 5 Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 6. 6 The Palliative Care Team Funen, Department of Oncology, Odense University Hospital, Odense, Denmark. 7. 7 Department of Palliative Care, Naestved Hospital, Naestved, Denmark. 8. 8 Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: The utilization of the health care system varies in relation to cohabitation status, but conflicting results have been found in studies investigating the association in relation to specialized palliative care (SPC). OBJECTIVE: To investigate the association between cohabitation status and admittance to SPC; to establish whether this association differed between hospital-based palliative care team/units (mainly outpatient/home care) and hospice (mainly inpatient care). DESIGN: A nationwide study based on the Danish Palliative Care Database, which is linked with additional registers. MEASUREMENTS: The study population included all patients dying from cancer in Denmark between 2010 and 2012 (n = 44,480). The associations were investigated using logistic regression analysis adjusted for sex, age, diagnosis, and geography and standardized absolute prevalences. RESULTS: Comparison with cohabiting patients showed that overall admittance to SPC was lowest among patients who were widows/widowers (odds ratio [OR] = 0.86; 95% confidence interval [CI]: 0.81-0.91) and those who had never married (OR = 0.74; 95% CI: 0.68-0.80). Patients living alone were more likely to be admitted to a hospice [e.g., divorced OR = 1.41 (95% CI: 1.31-1.52)] than to a hospital-based palliative care team/unit [e.g., never married OR = 0.64 (95% CI: 0.59-0.70)] compared with cohabiting patients. Standardized prevalences of overall admittance to SPC showed a similar pattern, for example, admittance was highest (41%) for patients cohabiting and lowest (30%) for patients who had never married. CONCLUSION: Cohabiting individuals were favored in admittance to SPC. Compared with cohabiting patients it is unlikely that patients living alone have lower needs for SPC: results point toward inequity in admittance to specialist health care, a problem that should be addressed.
BACKGROUND: The utilization of the health care system varies in relation to cohabitation status, but conflicting results have been found in studies investigating the association in relation to specialized palliative care (SPC). OBJECTIVE: To investigate the association between cohabitation status and admittance to SPC; to establish whether this association differed between hospital-based palliative care team/units (mainly outpatient/home care) and hospice (mainly inpatient care). DESIGN: A nationwide study based on the Danish Palliative Care Database, which is linked with additional registers. MEASUREMENTS: The study population included all patients dying from cancer in Denmark between 2010 and 2012 (n = 44,480). The associations were investigated using logistic regression analysis adjusted for sex, age, diagnosis, and geography and standardized absolute prevalences. RESULTS: Comparison with cohabiting patients showed that overall admittance to SPC was lowest among patients who were widows/widowers (odds ratio [OR] = 0.86; 95% confidence interval [CI]: 0.81-0.91) and those who had never married (OR = 0.74; 95% CI: 0.68-0.80). Patients living alone were more likely to be admitted to a hospice [e.g., divorced OR = 1.41 (95% CI: 1.31-1.52)] than to a hospital-based palliative care team/unit [e.g., never married OR = 0.64 (95% CI: 0.59-0.70)] compared with cohabiting patients. Standardized prevalences of overall admittance to SPC showed a similar pattern, for example, admittance was highest (41%) for patients cohabiting and lowest (30%) for patients who had never married. CONCLUSION: Cohabiting individuals were favored in admittance to SPC. Compared with cohabiting patients it is unlikely that patients living alone have lower needs for SPC: results point toward inequity in admittance to specialist health care, a problem that should be addressed.
Entities:
Keywords:
epidemiologic studies; health service accessibility; hospice care; marital status; neoplasms; palliative care
Authors: Jens-Jakob Kjer Møller; Karen la Cour; Marc Sampedro Pilegaard; Sören Möller; Lene Jarlbaek Journal: Support Care Cancer Date: 2022-03-11 Impact factor: 3.603