• J Palliat Med · Oct 2011

    Is individual educational level related to end-of-life care use? Results from a nationwide retrospective cohort study in Belgium.

    • Nathalie Bossuyt, Lieve Van den Block, Joachim Cohen, Koen Meeussen, Johan Bilsen, Michael Echteld, Luc Deliens, and Viviane Van Casteren.
    • Scientific Institute of Public Health, Operational Directorate Public Health & Surveillance, Brussels, Belgium. nathalie.bossuyt@wiv-isp.be
    • J Palliat Med. 2011 Oct 1;14(10):1135-41.

    BackgroundEducational level has repeatedly been identified as an important determinant of access to health care, but little is known about its influence on end-of-life care use.ObjectivesTo examine the relationship between individual educational attainment and end-of-life care use and to assess the importance of individual educational attainment in explaining differential end-of-life care use.Research DesignA retrospective cohort study via a nationwide sentinel network of general practitioners (GPs; SENTI-MELC Study) provided data on end-of-life care utilization. Multilevel analysis was used to model the association between educational level and health care use, adjusting for individual and contextual confounders based upon Andersen's behavioral model of health services use.SubjectsA Belgian nationwide representative sample of people who died not suddenly in 2005-2007.ResultsIn comparison to their less educated counterparts, higher educated people equally often had a palliative treatment goal but more often used multidisciplinary palliative care services (odds ratios [OR] for lower secondary education 1.28 [1.04-1.59] and for higher [secondary] education: 1.31 [1.02-1.68]), moved between care settings more frequently (OR: 1.68 [1.13-2.48] for lower secondary education and 1.51 [0.93-2.48] for higher [secondary] education) and had more contacts with the GP in the final 3 months of life.ConclusionsLess well-educated people appear to be disadvantaged in terms of access to specialist palliative care services, and GP contacts at the end of life, suggesting a need for empowerment of less well-educated terminally ill people regarding specialist palliative and general end-of-life care use.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…