Equity of access to adult hospice inpatient care within north-west England

• Published in: Palliative medicine 2004-09, Vol.18 (6), p.543-549
• Main Authors: Wood, D J, Clark, D, Gatrell, A C
• Format: Article
• Language: English
• Subjects: Accessibility; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Clinical death. Palliative care. Organ gift and preservation; England; England - epidemiology; Equity; Geographic Information Systems; Health Services Accessibility - statistics & numerical data; Hospices; Hospices - supply & distribution; Hospitalization - statistics & numerical data; Humans; Intensive care medicine; Medical sciences; Middle Aged; Needs Assessment; Neoplasms - mortality; Palliative care; Poverty - statistics & numerical data; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0269-2163; 1477-030X
• DOI: 10.1191/0269216304pm892oa

There is a growing debate about the question of equity of access to hospice and palliative care services. Even countries with relatively well developed palliative care systems are considered to have problems of access and inequity of provision. Despite these concerns, we still lack a relevant evidence base to serve as a guide to action. We present an analysis of access to adult hospice inpatient provision in the north-west region of England that employs Geographical Information Systems (GIS). Measures of the possible demand for, and supply of, hospice inpatient services are used to determine the potential accessibility of cancer patients, assessed at the level of small areas (electoral wards). Further, the use of deprivation scores permits an analysis of the equity of access to adult inpatient hospice care, leading to the identification of areas where additional service provision may be warranted. Our research is subject to a number of caveats–it is limited to inpatient hospice provision and does not include other kinds of inpatient and community-based palliative care services. Likewise, we recognise that not everyone with cancer will require palliative care and also that palliative care needs exist among those with nonmalignant conditions. Nevertheless, our methodology is one that can also be applied more generally.