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Int. J. Environ. Res. Public Health 2017, 14(7), 802; doi:10.3390/ijerph14070802

Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada

1
School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, Hubei, China
2
Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
3
Canadian Centre for Health Economics, 155 College Street, Toronto, ON M5T 3M6, Canada
*
Author to whom correspondence should be addressed.
Academic Editor: Luke Connelly
Received: 19 June 2017 / Revised: 10 July 2017 / Accepted: 13 July 2017 / Published: 18 July 2017
(This article belongs to the Special Issue Insurance and Health)
View Full-Text   |   Download PDF [294 KB, uploaded 19 July 2017]

Abstract

The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed. A total of 181 caregivers were interviewed biweekly over the course of the palliative care trajectory, yielding a total of 994 interviews. The propensity and intensity of health service use were examined using logistic regression and negative binomial regression, respectively. The results demonstrated that both the propensity and intensity of home-based nurse and PSW visits fell with socioeconomic status. The use of home-based palliative care services was not concentrated in high socioeconomic status groups. The common predictors of health service use in the three service categories were patient age, the Palliative Performance Scale (PPS) score and place of death. These findings may assist health service planners in the appropriate allocation of resources and service packages to meet the complex needs of palliative care populations. View Full-Text
Keywords: Canada; home-based care; socioeconomic difference; health service use Canada; home-based care; socioeconomic difference; health service use
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Cai, J.; Guerriere, D.N.; Zhao, H.; Coyte, P.C. Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada. Int. J. Environ. Res. Public Health 2017, 14, 802.

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