Project PEOLC01

Who is (not) referred for hospice care? A systematic literature review and narrative synthesis

Inequalities in access to hospice care is a source of considerable concern. This study seeks to identify from the literature the demographic characteristics of those who access hospice care more often, focusing on; diagnosis, age, gender, marital status, ethnicity, geography and socio-economic status.

 

Summary

Inequalities in access to hospice care is a source of considerable concern; white, middle-class, middle-aged, cancer patients have traditionally been over-represented in hospice populations.

Project aims

This study has undertaken a systematic review and narrative synthesis of the literature concerning the demographic characteristics of those who access hospice care more often, focusing on; diagnosis, age, gender, marital status, ethnicity, geography and socio-economic status.

Project activity

An extensive literature search demonstrates persistent inequalities in hospice care provision: non-cancer patients, the oldest old, ethnic minorities and those living in rural or deprived areas are under-represented in hospice populations. The effect of gender and marital status is inconsistent. There is a limited literature concerning hospice service access for the LGBTQ+ community, homeless people and those living with HIV/AIDS, diabetes and cystic fibrosis.

Barriers of prognostic uncertainty, institutional cultures, particular needs of certain groups and lack of public awareness of hospice services remain substantial challenges to the hospice movement in ensuring equitable access for all. 

What we found and what this means

This study is now completed, with the paper published in February 2021. The key findings have been presented at several national conferences.

A new study, further investigating inequalities in access to hospice care, is currently under development.

Who is involved?

Principle Investigator

Professor Stephen Barclay (Sigb2@medschl.cam.ac.uk), University of Cambridge

Researchers and institutions

Contact us

Professor Stephen Barclay, Sigb2@medschl.cam.ac.uk

PEOLC01