title: Equity of use of specialist palliative care by age: cross-sectional study of lung cancer patients.
abstract: The equitable provision of care is a core principle of the National Health Service. Previous research has suggested that older cancer patients may be less likely to use specialist palliative care, but such research has been limited by retrospective design and the failure to measure clinical need. The objective of this study was to examine the extent to which the use of specialist palliative care in lung cancer patients varies by age, after accounting for need. A cross-sectional survey of patients and their carers attending four hospital lung cancer clinics in London was conducted between June 2006 and April 2007. Two hundred and fifty-two patients and 137 carers participated in the study. Thirty-nine percent of participants received specialist palliative care. Metastatic disease, global quality of life and the clinic where treatment was provided were associated with use of specialist palliative care. Age, gender, deprivation, living alone, current or most recent line of treatment, number of co-morbidities and carer stress were not associated with receipt of such services. This suggests that, for patients within the specialist cancer care system, access to specialist palliative care is offered on the basis of need.
authors.affiliation: Institute of Public Health, University of Cambridge, Cambridge, UK. jab35@medschl.cam.ac.uk
authors.forename: Jenni
authors.initials: J
authors.lastname: Burt
authors.forename: Hilary
authors.initials: H
authors.lastname: Plant
authors.forename: Rumana
authors.initials: R
authors.lastname: Omar
authors.forename: Rosalind
authors.initials: R
authors.lastname: Raine
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008131:London; D008175:Lung Neoplasms / Q000451:nursing / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult