End of life care: socio-economic status as a predictor of access to palliative care services

Charlotte Wilson, Gunn Grande, M Campbell, Ann-Louise Caress

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review


Palliative care services aim to provide specialist care for the dying including; the palliation of symptoms and side effects and promotion of dignity & well-being towards the end of life. Equal access to these services is essential if health care services are to offer equitable provision to patients. The availability of hospice at home (H@H) services is particularly important in providing specialist palliative care (SPC) to the many people who prefer home care. In order to identify whether socio-economic factors are associated with SPC access, this population study explored how socio-economic status and other key demographic indicators were associated with referral rates in two socioeconomically distinct areas (Salford and Trafford). These areas were served by the same H@H service so provision was held constant. Secondary data from the UK National Census 2001, North West Cancer Intelligence Agency and H@H Service referral data (2004-06) were collated for both areas. Descriptive analysis profiled electoral ward characteristics whilst simple correlations and regression modelling estimated associations with referral rates. Referral rates were lower and cancer mortality higher in most deprived wards (Salford). Referral rates were significantly associated with deprivation – particularly multiple deprivation – but not significantly associated with cancer mortality. The socio-economic characteristics of those referred to hospice at home rather than service provision strongly predicted referral rates, suggesting that lower socio-economic status is associated with poorer access. This has implications for the allocation and targeting of resources and contributes important findings to future research exploring relationships between socio-economic status and care for the dying.
Original languageEnglish
Title of host publicationhost publication
Publication statusPublished - Dec 2009
EventBritish Sociological Association: Death, Dying & Bereavement - Sheffield University
Duration: 13 Nov 200913 Nov 2009


ConferenceBritish Sociological Association: Death, Dying & Bereavement
CitySheffield University


  • end-of-life social class palliative care hospice


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