Exploring socioeconomic inequities in access to palliative and end-of-life care in the UK: a narrative synthesis

Article


French, M., Keegan, T., Anestis, E. and Preston, N. 2021. Exploring socioeconomic inequities in access to palliative and end-of-life care in the UK: a narrative synthesis. BMC Palliative Care. 20 (1). https://doi.org/10.1186/s12904-021-00878-0
TypeArticle
TitleExploring socioeconomic inequities in access to palliative and end-of-life care in the UK: a narrative synthesis
AuthorsFrench, M., Keegan, T., Anestis, E. and Preston, N.
Abstract

Background: Efforts to tackle socioeconomic inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities. Most research on this topic examines differences in receipt of care. There is a need, particularly in the UK, for theoretically driven research that considers both receipt of care and the wider factors influencing the relationship between socioeconomic position and access to palliative and end-of-life care. Methods: This is a mixed studies narrative synthesis on socioeconomic position and access to palliative and end-of-life care in the UK. Study searches were conducted in databases AMED, Medline, Embase, CINAHL, SocIndex, and Academic Literature Search, as well as grey literature sources, in July 2020. The candidacy model of access, which describes access as a seven-stage negotiation between patients and providers, guided study searches and provided a theoretical lens through which data were synthesised. Results: Searches retrieved 5303 studies (after de-duplication), 29 of which were included. The synthesis generated four overarching themes, within which concepts of candidacy were evident: identifying needs; taking action; local conditions; and receiving care. Conclusion: There is not a consistent or clear narrative regarding the relationship between socioeconomic position and receipt of palliative and end-of-life care in the UK. Attempts to address any inequities in access will require knowledge and action across many different areas. Key evidence gaps in the UK literature concern the relationship between socioeconomic position, organisational context, and assessing need for care.

KeywordsAccess to healthcare; End-of-life care; Healthcare utilisation; Palliative care; Socioeconomic position; adult; Cinahl; Embase; female; grey literature; health care utilization; human; male; Medline; narrative; negotiation; palliative therapy; synthesis; systematic review; terminal care; theoretical study
Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
PublisherBioMed Central
JournalBMC Palliative Care
ISSN
Electronic1472-684X
Publication dates
Online21 Nov 2021
Print21 Nov 2021
Publication process dates
Deposited24 May 2023
Submitted11 May 2021
Accepted05 Nov 2021
Output statusPublished
Publisher's version
License
File Access Level
Open
Digital Object Identifier (DOI)https://doi.org/10.1186/s12904-021-00878-0
Web of Science identifierWOS:000720831400001
LanguageEnglish
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