title: Trend of urban-rural disparities in hospice utilization in Taiwan.
abstract: OBJECTIVE
  The palliative care has spread rapidly worldwide in the recent two decades. The development of hospice services in rural areas usually lags behind that in urban areas. The aim of our study was to investigate whether the urban-rural disparity widens in a country with a hospital-based hospice system.
  
  
  METHODS
  From the nationwide claims database within the National Health Insurance in Taiwan, admissions to hospices from 2000 to 2006 were identified. Hospices and patients in each year were analyzed according to geographic location and residence.
  
  
  RESULTS
  A total of 26,292 cancer patients had been admitted to hospices. The proportion of rural patients to all patients increased with time from 17.8% in 2000 to 25.7% in 2006. Although the numbers of beds and the utilizations in both urban and rural hospices expanded rapidly, the increasing trend in rural areas was more marked than that in urban areas. However, still two-thirds (898/1,357) of rural patients were admitted to urban hospices in 2006.
  
  
  CONCLUSIONS
  The gap of hospice utilizations between urban and rural areas in Taiwan did not widen with time. There was room for improvement in sufficient supply of rural hospices or efficient referral of rural patients.
authors: Department of Family Medicine, Kaohsiung Veterans General Hospital Pingtung Branch, Pingtung, Taiwan.
authors: Yi-Hsuan
authors: YH
authors: Lin
authors: Yi-Chun
authors: YC
authors: Chen
authors: Yen-Han
authors: YH
authors: Tseng
authors: Ming-Hwai
authors: MH
authors: Lin
authors: Shinn-Jang
authors: SJ
authors: Hwang
authors: Tzeng-Ji
authors: TJ
authors: Chen
authors: Li-Fang
authors: LF
authors: Chou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D054625:Healthcare Disparities / Q000639:trends*; D017051:Hospice Care / Q000706:statistics & numerical data; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000600:supply & distribution / Q000639:trends*; D013624:Taiwan; D019037:Urban Health Services / Q000600:supply & distribution / Q000639:trends*
references: J Pain Symptom Manage. 2007 Sep;34(3):277-85
references: 17590566
references: J Palliat Care. 2003 Winter;19(4):230-7
references: 14959592
references: Palliat Med. 2005 Jun;19(4):319-27
references: 15984504
references: J Palliat Med. 2008 Apr;11(3):438-43
references: 18363486
references: J Cross Cult Gerontol. 2010 Mar;25(1):1-19
references: 20054707
references: Health Soc Care Community. 2010 Sep;18(5):537-48
references: 20561070
references: J Chin Med Assoc. 2008 Jun;71(6):294-9
references: 18567559
references: Int J Environ Health Res. 2003 Jun;13(2):107-15
references: 12745333
references: BMJ. 2006 Mar 4;332(7540):515-21
references: 16467346
references: Psychooncology. 2010 Nov;19(11):1213-20
references: 20119936
references: BMJ. 2011 Feb 01;342:d637
references: 21285219
references: J Nurs Scholarsh. 2009;41(4):420-8
references: 19941588
references: BMC Health Serv Res. 2006 May 04;6:54
references: 16672073
references: Palliat Med. 2007 Sep;21(6):463-71
references: 17846085
references: Intern Med J. 2010 Nov;40(11):772-6
references: 19811557
references: J Palliat Care. 2006 Spring;22(1):46-50
references: 16689415
references: Am J Hosp Palliat Care. 2013 Sep;30(6):576-8
references: 22956339
references: Indian J Palliat Care. 2009 Jul;15(2):122-6
references: 20668590
references: Asia Pac J Clin Oncol. 2010 Sep;6(3):197-202
references: 20887501
references: JAMA. 1996 Jun 26;275(24):1907-14
references: 8648872
references: J Rural Health. 2010 Winter;26(1):78-84
references: 20105272
references: BMJ. 2004 Mar 13;328(7440):607
references: 15016692
references: J Am Geriatr Soc. 2004 May;52(5):731-5
references: 15086653