• Joanna M Davies, Katherine E Sleeman, Christina Ramsenthaler, Wendy Prentice, Matthew Maddocks, and Fliss Em Murtagh.
• Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
• Palliat Med. 2023 Apr 1; 37 (4): 575585575-585.

BackgroundUnderstanding how socioeconomic position influences the symptoms and concerns of patients approaching the end of life is important for planning more equitable care. Data on this relationship is lacking, particularly for patients with non-cancer conditions.AimTo analyse the association between socioeconomic position and the symptoms and concerns of older adult patients seen by specialist palliative care.DesignSecondary analysis of cross-sectional, routinely collected electronic patient data. We used multivariable linear regression with robust standard errors, to predict scores on the three subscales of the Integrated Palliative care Outcome Scale (IPOS; physical symptoms, emotional symptoms and communication and practical concerns) based on patient level of deprivation, measured using Index of Multiple Deprivation.Setting/ParticipantsConsecutive inpatients aged 60 years and over, seen by specialist palliative care at two large teaching hospitals in London between 1st January 2016 and 31st December 2019.ResultsSeven thousand eight hundred and sixty patients were included, 38.3% had cancer. After adjusting for demographic and clinical characteristics, patients living in the most deprived areas had higher (worse) predicted mean scores on the communication and practical subscale than patients living in the least deprived areas, 5.38 (95% CI: 5.10, 5.65) compared to 4.82 (4.62, 5.02) respectively. This effect of deprivation diminished with increasing age. Deprivation was not associated with scores on the physical or emotional symptoms subscales.ConclusionsTargetting resources to address practical and communication concerns could be a strategy to reduce inequalities. Further research in different hospitals and across different settings using patient centred outcome measures is needed to examine inequalities.

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