title: Access to outreach specialist palliative care teams among cancer patients in Denmark.
abstract: BACKGROUND
  Equal access to end-of-life care is important. However, social inequality has been found in relation to place-of-death. The question is whether social and economic factors play a role in access to specialist palliative care services.
  
  
  OBJECTIVE
  The study analyzed the association between access to outreach specialist palliative care teams (SPCTs) and socioeconomic characteristics of Danish cancer patients who died of their cancer.
  
  
  METHODS
  The study was a population-based, cross-sectional register study. We identified 599 adults who had died of cancer from March 1 to November 30, 2006, in Aarhus County, Denmark. Data from health registers were retrieved and linked based on the unique personal identifier number.
  
  
  RESULTS
  Multivariate analysis with adjustment for age, gender, and general practitioner (GP) involvement showed a higher probability of contact with an SPCT among immigrants and descendants of immigrants than among people of Danish origin (prevalence ratio [PR]: 1.55; 95% confidence interval (CI): 1.04;2.31) and among married compared to unmarried patients (PR: 1.25; 95% CI: 1.01;1.54). The trends were most marked among women.
  
  
  CONCLUSIONS
  We found an association between females, married patients, and female immigrants and their descendants and access to an SPCT in Denmark. However, no association with the examined economic factor was found. Need for specialized health care, which is supposed to be the main reason for access to an SPCT, may be related to economic imbalance; and despite the relative equality found, SPCT access may not be equal for all Danish residents. Further research into social and economic consequences in palliative care services is warranted.
authors: The Palliative Team, Aarhus University Hospital, Aarhus, Denmark. mettneer@rm.dk
authors: Mette Asbjoern
authors: MA
authors: Neergaard
authors: Anders Bonde
authors: AB
authors: Jensen
authors: Frede
authors: F
authors: Olesen
authors: Peter
authors: P
authors: Vedsted
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003159:Community-Institutional Relations; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000503:physiopathology / Q000628:therapy*; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D012042:Registries; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013038:Specialization; D013727:Terminal Care / Q000458:organization & administration*; D000078329:Workforce; D055815:Young Adult