Persistent inequalities in Hospice at Home provision.
BMJ supportive & palliative care
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Buck, J., Webb, L., Moth, L., Morgan, L., & Barclay, S. (2020). Persistent inequalities in Hospice at Home provision.. BMJ supportive & palliative care, 10 (3), e23. https://doi.org/10.1136/bmjspcare-2017-001367
Abstract Objective: To describe the nature and scope of a new Hospice at Home service and to identify its equality of provision. Methods: Case note review of patients supported by a Hospice at Home service for one year from September 2012 to August 2013 (n=321). Descriptive analysis to report frequencies and proportions of quantitative data extracted from service logs, referral forms and care records; thematic analysis of qualitative data from care record free text. Results: Demand outstripped supply. Twice as many night care episodes were requested (n=1237) as were provided (n=613). Inequalities in access to the service related to underlying diagnosis and socioeconomic status. 75% of patients using the service had cancer (221/293 with documented diagnosis). Of those who died at home in the areas surrounding the hospice, 53% (163/311) of people with cancer and 11% (49/431) of those without cancer received Hospice at Home support. People who received Hospice at Home care were often more affluent than the population average for the area within which they lived. Roles of the service identified included: care planning/implementation, specialist end of life care assessment and advice, ‘holding’ complex patients until hospice beds become available, and clinical nursing care. Conclusion: There is significant unmet need and potentially large latent demand for the Hospice at Home service. People without cancer or of lower socio-economic status are less likely to access the service. Action is needed to ensure greater and more equitable service provision in this and similar services nationally and internationally.
Humans, Neoplasms, Hospice Care, Health Care Surveys, Socioeconomic Factors, Home Care Services, Referral and Consultation, Health Services Accessibility, Female, Male, Healthcare Disparities, Hospice and Palliative Care Nursing
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (unknown)
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External DOI: https://doi.org/10.1136/bmjspcare-2017-001367
This record's URL: https://www.repository.cam.ac.uk/handle/1810/275365
Attribution-NonCommercial 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc/4.0/