Social class variation in place of cancer death

Abstract

The aim of this research was to describe the distribution of place of death for cancer. An analysis of place of death for all 831 cancer deaths in 1995 among Doncaster Health Authority's residents was carried out. The data were extracted using the Public Health Mortality File. It was found that there is statistically significant evidence that place of death is associated with social class. Social class I and II with 15% of all cancer deaths contributed 24% of hospice deaths, 14% of hospital deaths and 12% of home deaths. Social class III with 24% of all cancer deaths contributed 58% of hospice deaths, only 9% of hospital deaths and 35% of home deaths. Social classes IV and V with 61% of cancer deaths contributed only 18% of hospice deaths, 77% of hospital deaths and 53% of home deaths. The reasons for these differences may be to do with access to services, perceptions of different services by patients and general practitioners and the availability of social support within different sections of the community.

Predictors of Home Care Expenditures and Death at Home for Cancer Patients in an Integrated Comprehensive Palliative Home Care Pilot Program

“…In previous studies, older age, male gender, higher socioeconomic status, access to a daughter as a caregiver, stable caregiver health, a preference for home death and the number of informal caregivers have been factors associated with home death (Addington-Hall and McCarthy 1995;Axelson and Christensen 1996;Cantwell et al 2000;gomes and Higginson 2006;grand et al 1998;Higginson et al 1999;karlsen and Addington-Hall 1998;Lock and Higginson 2005;Moinpour and Polissar 1989;Roder et al 1997;sims et al 1997;Tang and McCorkle 2001). In contrast, EOL hospitalization is associated with a diagnosis of haematological cancer, extended period of functional decline preceding death, shorter time from diagnosis to death, unrelieved symptoms such as breathlessness, patient confusion, informal caregiver burden and emotional distress (berry et al 1994;brazil et al 2002;bruera et al 1990;Mann et al 1993).…”

Hospice at Home service: the carer’s perspective

“…Most studies of domiciliary palliative care focus on place of death, cost, patterns of usage and demographic characteristics of home care patients [3,[11][12][13][14]. Although Tyrer and Exley [15] claim that such services play an important role in the provision of care for people who choose to die at home, there have been few published evaluations of end-of-life services delivered in the home [16] and little research has been undertaken to explore the caregivers' views about their experience after the patient has died [17].…”

Understanding community engagement in end-of-life care: developing conceptual clarity

“…Inequity of access has been highlighted (Sims, Radford, Doran, & Page, 1997), as has the often limited interpretation of holistic care, focusing on physical or psychological symptom burden at the expense of social or spiritual needs (Kearney, 1992). The field has also been criticised for becoming increasingly professionally led and fostering dependence on professionals, rather than on individual coping (Randall & Downie, 2006, p. 149).…”