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BMC Palliative Care
Published in: BMC Palliative Care 1/2017

Open Access 01-12-2017 | Research article

Is admittance to specialised palliative care among cancer patients related to sex, age and cancer diagnosis? A nation-wide study from the Danish Palliative Care Database (DPD)

Authors: Mathilde Adsersen, Lau Caspar Thygesen, Anders Bonde Jensen, Mette Asbjoern Neergaard, Per Sjøgren, Mogens Groenvold

Published in: BMC Palliative Care | Issue 1/2017

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Abstract

Background

Specialised palliative care (SPC) takes place in specialised services for patients with complex symptoms and problems. Little is known about what determines the admission of patients to SPC and whether there are differences in relation to institution type. The aims of the study were to investigate whether cancer patients’ admittance to SPC in Denmark varied in relation to sex, age and diagnosis, and whether the patterns differed by type of institution (hospital-based palliative care team/unit, hospice, or both).

Methods

This was a register-based study of adult patients living in Denmark who died from cancer in 2010–2012. Data sources were the Danish Palliative Care Database, Danish Register of Causes of Death and Danish Cancer Registry. The associations between the explanatory variables (sex, age, diagnosis) and admittance to SPC were investigated using logistic regression.

Results

In the study population (N = 44,548) the overall admittance proportion to SPC was 37%. Higher odds of overall admittance to SPC were found for women (OR = 1.23; 1.17–1.28), younger patients (<40 compared with 80+ years old) (OR = 6.44; 5.19–7.99) and patients with sarcoma, pancreatic and stomach cancers, whereas the lowest were for patients with haematological malignancies. The higher admission found for women was most pronounced for hospices compared to hospital-based palliative care teams/units, whereas higher admission of younger patients was more pronounced for hospital-based palliative care teams/units. Patients with brain cancer were more often admitted to hospices, whereas patients with prostate cancer were more often admitted to hospital-based palliative care teams/units.

Conclusion

It is unlikely that the variations in relation to sex, age and cancer diagnoses can be fully explained by differences in need. Future research should investigate whether the groups having the lowest admittance to SPC receive sufficient palliative care elsewhere.
Literature
1.
Radbruch L, Payne S. White Paper on standards and norms for hospice and palliative care in Europe: part 1. Eur J Palliat Care. 2009;16(6):278–89.
2.
Hansen MB, Grønvold M. Danish palliative care database annual report 2012. In: Danish: Dansk Palliativ Database Årsrapport 2012. København: DMCG-PAL; 2013.
3.
Walshe C, Todd C, Caress A, Chew-Graham C. Patterns of Access to Community Palliative Care Services: A Literature Review. J Pain Symptom Manage. 2009;37(5):884–912.
4.
Broom A, Kirby E, Good P. Referral to specialist palliative care. Intern Med J. 2012;42(9):1040–2.
5.
Johnsen AT, Petersen MA, Pedersen L, Groenvold M. Symptoms and problems in a nationally representative sample of advanced cancer patients. Palliat Med. 2009;23(6):491–501.
6.
Johnsen AT, Tholstrup D, Petersen MA, Pedersen L, Groenvold M. Health related quality of life in a nationally representative sample of haematological patients. Eur J Haematol. 2009;83(2):139–48.
7.
Grønvold M, Hansen MB, Rasmussen M. Danish palliative care database annual report 2011. In: Danish: Dansk Palliativ Database Årsrapport 2011. København: DMCG-PAL; 2012.
8.
Lynge E, Sandegaard JL, Rebolj M. The Danish National Patient Register. Scand J Public Health. 2011;39(7 Suppl):30–3.
9.
Grønvold M, Rasmussen M, Hansen KH. Danish palliative care database annual report 2010. In: Danish: Dansk Palliativ Database Årsrapport 2010. Københvan: DMCG-PAL; 2011.
10.
Helweg-Larsen K. The Danish Register of Causes of Death. Scand J Public Health. 2011;39(7 Suppl):26–9.
11.
Gjerstorff ML. The Danish Cancer Registry. Scand J Public Health. 2011;39(7 Suppl):42–5.
12.
SAS Institute INC. SAS/STAT 9.3 Users’s Guide. Cary: SAS Institute Inc.; 2011.
13.
Pedersen CB. The Danish Civil Registration System. Scand J Public Health. 2011;39(7 Suppl):22–5.
14.
Thygesen LC, Ersboll AK. When the entire population is the sample: strengths and limitations in register-based epidemiology. Eur J Epidemiol. 2014;29(8):551–8.
15.
Fadul N, Elsayem A, Palmer JL, Zhang T, Braiteh F, Bruera E. Predictors of access to palliative care services among patients who died at a comprehensive cancer center. J Palliat Med. 2007;10(5):1146–52.
16.
Rosenwax L, Spilsbury K, Mcnamara BA, Semmens JB. A retrospective population based cohort study of access to specialist palliative care in the last year of life: who is still missing out a decade on? BMC Palliat Care. 2016;10:15.
17.
Lackan NA, Ostir GV, Freeman JL, Mahnken JD, Goodwin JS. Decreasing variation in the use of hospice among older adults with breast, colorectal, lung, and prostate cancer. Med Care. 2004;42(2):116–22.
18.
Virnig BA, Mcbean AM, Kind S, Dholakia R. Hospice use before death - Variability across cancer diagnoses. Med Care. 2002;40(1):73–8.
19.
Skulason B, Hauksdottir A, Ahcic K, Helgason AR. Death talk: gender differences in talking about one’s own impending death. BMC Palliat Care. 2014;13(1):8.
20.
Fletcher K, Prigerson HG, Paulk E, Temel J, Finlay E, Marr L, et al. Gender differences in the evolution of illness understanding among patients with advanced cancer. J Support Oncol. 2013;11(3):126–32.
21.
Burt J, Raine R. The effect of age on referral to and use of specialist palliative care services in adult cancer patients: a systematic review. Age and Ageing. 2006;35(5):469–76.
22.
Burge FI, Lawson BJ, Johnston GM, Grunfeld E. A Population-based Study of Age Inequalities in Access to Palliative Care Among Cancer Patients. Med Care. 2008;46(12):1203–11.
23.
Hunt RW, Fazekas BS, Luke CG, Priest KR, Roder DM. The coverage of cancer patients by designated palliative services: a population-based study, South Australia, 1999. Palliat Med. 2002;16(5):403–9.
24.
Maddison AR, Asada Y, Burge F, Johnston GW, Urquhart R. Inequalities in end-of-life care for colorectal cancer patients in Nova Scotia, Canada. J Palliat Care. 2012;28(2):90–6.
25.
Rosenwax LK, McNamara BA. Who receives specialist palliative care in Western Australia - and who misses out. Palliat Med. 2006;20(4):439–45.
26.
Howell DA, Shellens R, Roman E, Garry AC, Patmore R, Howard MR. Haematological malignancy: are patients appropriately referred for specialist palliative and hospice care? A systematic review and meta-analysis of published data. Palliat Med. 2011;25(6):630–41.
27.
Hui D, Kim SH, Kwon JH, Tanco KC, Zhang T, Kang JH, et al. Access to palliative care among patients treated at a comprehensive cancer center. Oncologist. 2012;17(12):1574–80.
28.
Ansell P, Howell D, Garry A, Kite S, Munro J, Roman E, et al. What determines referral of UK patients with haematological malignancies to palliative care services? An exploratory study using hospital records. Palliat Med. 2007;21(6):487–92.
29.
Cheng WW, Willey J, Palmer JL, Zhang T, Bruera E. Interval between palliative care referral and death among patients treated at a comprehensive cancer center. J Palliat Med. 2005;8(5):1025–32.
30.
Hui D, Didwaniya N, Vidal M, Shin SH, Chisholm G, Roquemore J, et al. Quality of end-of-life care in patients with hematologic malignancies: a retrospective cohort study. Cancer. 2014;15:120(10):1572–8.
31.
Sexauer A, Cheng MJ, Knight L, Riley AW, King L, Smith TJ. Patterns of hospice use in patients dying from hematologic malignancies. J Palliat Med. 2014;17(2):195–9.
32.
Neergaard MA, Jensen AB, Olesen F, Vedsted P. Access to Outreach Specialist Palliative Care Teams among Cancer Patients in Denmark. J Palliat Med. 2013;16(8):951–7.
Metadata
Title
Is admittance to specialised palliative care among cancer patients related to sex, age and cancer diagnosis? A nation-wide study from the Danish Palliative Care Database (DPD)
Authors
Mathilde Adsersen
Lau Caspar Thygesen
Anders Bonde Jensen
Mette Asbjoern Neergaard
Per Sjøgren
Mogens Groenvold
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2017
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-017-0194-z

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