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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Cohabitation Status Influenced Admittance to Specialized Palliative Care for Cancer Patients: A Nationwide Study from the Danish Palliative Care Database

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BACKGROUND: The utilization of the health care system varies in relation to cohabitation status, but conflicting results have been found in studies investigating the association in relation to specialized palliative care (SPC).

OBJECTIVE: To investigate the association between cohabitation status and admittance to SPC; to establish whether this association differed between hospital-based palliative care team/units (mainly outpatient/home care) and hospice (mainly inpatient care).

DESIGN: A nationwide study based on the Danish Palliative Care Database, which is linked with additional registers.

MEASUREMENTS: The study population included all patients dying from cancer in Denmark between 2010 and 2012 (n = 44,480). The associations were investigated using logistic regression analysis adjusted for sex, age, diagnosis, and geography and standardized absolute prevalences.

RESULTS: Comparison with cohabiting patients showed that overall admittance to SPC was lowest among patients who were widows/widowers (odds ratio [OR] = 0.86; 95% confidence interval [CI]: 0.81-0.91) and those who had never married (OR = 0.74; 95% CI: 0.68-0.80). Patients living alone were more likely to be admitted to a hospice [e.g., divorced OR = 1.41 (95% CI: 1.31-1.52)] than to a hospital-based palliative care team/unit [e.g., never married OR = 0.64 (95% CI: 0.59-0.70)] compared with cohabiting patients. Standardized prevalences of overall admittance to SPC showed a similar pattern, for example, admittance was highest (41%) for patients cohabiting and lowest (30%) for patients who had never married.

CONCLUSION: Cohabiting individuals were favored in admittance to SPC. Compared with cohabiting patients it is unlikely that patients living alone have lower needs for SPC: results point toward inequity in admittance to specialist health care, a problem that should be addressed.

Original languageEnglish
JournalJournal of Palliative Medicine
Volume22
Issue number2
Pages (from-to)164-172
Number of pages9
ISSN1096-6218
DOIs
Publication statusPublished - Feb 2019

    Research areas

  • epidemiologic studies, health service accessibility, hospice care, marital status, neoplasms, palliative care

ID: 55863831