Joanna M Davies
The association between socioeconomic position and the symptoms and concerns of hospital inpatients seen by specialist palliative care: Analysis of routinely collected patient data
Davies, Joanna M; Sleeman, Katherine E; Ramsenthaler, Christina; Prentice, Wendy; Maddocks, Matthew; Murtagh, Fliss E.M.
Katherine E Sleeman
Professor Fliss Murtagh F.Murtagh@hull.ac.uk
Professor of Palliative Care
Background: Understanding how socioeconomic position influences the symptoms and concerns of patients approaching the end of life is important for planning more equitable care. Data on this relationship is lacking, particularly for patients with non-cancer conditions. Aim: To analyse the association between socioeconomic position and the symptoms and concerns of older adult patients seen by specialist palliative care. Design: Secondary analysis of cross-sectional, routinely collected electronic patient data. We used multivariable linear regression with robust standard errors, to predict scores on the three subscales of the Integrated Palliative care Outcome Scale (IPOS; physical symptoms, emotional symptoms and communication and practical concerns) based on patient level of deprivation, measured using Index of Multiple Deprivation. Setting/participants: Consecutive inpatients aged 60 years and over, seen by specialist palliative care at two large teaching hospitals in London between 1st January 2016 and 31st December 2019. Results: Seven thousand eight hundred and sixty patients were included, 38.3% had cancer. After adjusting for demographic and clinical characteristics, patients living in the most deprived areas had higher (worse) predicted mean scores on the communication and practical subscale than patients living in the least deprived areas, 5.38 (95% CI: 5.10, 5.65) compared to 4.82 (4.62, 5.02) respectively. This effect of deprivation diminished with increasing age. Deprivation was not associated with scores on the physical or emotional symptoms subscales. Conclusions: Targetting resources to address practical and communication concerns could be a strategy to reduce inequalities. Further research in different hospitals and across different settings using patient centred outcome measures is needed to examine inequalities.
Davies, J. M., Sleeman, K. E., Ramsenthaler, C., Prentice, W., Maddocks, M., & Murtagh, F. E. (2022). The association between socioeconomic position and the symptoms and concerns of hospital inpatients seen by specialist palliative care: Analysis of routinely collected patient data. Palliative medicine, https://doi.org/10.1177/02692163221115331
|Journal Article Type||Article|
|Acceptance Date||Jul 18, 2022|
|Online Publication Date||Aug 10, 2022|
|Publication Date||Aug 10, 2022|
|Deposit Date||Aug 22, 2022|
|Publicly Available Date||Oct 27, 2022|
|Peer Reviewed||Peer Reviewed|
|Keywords||Socioeconomic factors; Health equity; Symptom assessment; Palliative care|
Publisher Licence URL
© The Author(s) 2022.
https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).