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Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada

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  • Jiaoli Cai

    (School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, Hubei, China
    Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada)

  • Denise N. Guerriere

    (Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
    Canadian Centre for Health Economics, 155 College Street, Toronto, ON M5T 3M6, Canada)

  • Hongzhong Zhao

    (School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, Hubei, China)

  • Peter C. Coyte

    (Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
    Canadian Centre for Health Economics, 155 College Street, Toronto, ON M5T 3M6, Canada)

Abstract

The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed. A total of 181 caregivers were interviewed biweekly over the course of the palliative care trajectory, yielding a total of 994 interviews. The propensity and intensity of health service use were examined using logistic regression and negative binomial regression, respectively. The results demonstrated that both the propensity and intensity of home-based nurse and PSW visits fell with socioeconomic status. The use of home-based palliative care services was not concentrated in high socioeconomic status groups. The common predictors of health service use in the three service categories were patient age, the Palliative Performance Scale (PPS) score and place of death. These findings may assist health service planners in the appropriate allocation of resources and service packages to meet the complex needs of palliative care populations.

Suggested Citation

  • Jiaoli Cai & Denise N. Guerriere & Hongzhong Zhao & Peter C. Coyte, 2017. "Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada," IJERPH, MDPI, vol. 14(7), pages 1-12, July.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:7:p:802-:d:105001
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    References listed on IDEAS

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    1. Heidi H. Ewen & Tiffany R. Washington & Kerstin G. Emerson & Andrew T. Carswell & Matthew Lee Smith, 2017. "Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services," IJERPH, MDPI, vol. 14(3), pages 1-12, March.
    2. Marie-Josée Fleury & André Ngamini Ngui & Jean-Marie Bamvita & Guy Grenier & Jean Caron, 2014. "Predictors of Healthcare Service Utilization for Mental Health Reasons," IJERPH, MDPI, vol. 11(10), pages 1-28, October.
    3. Patrick Puhani, 2000. "The Heckman Correction for Sample Selection and Its Critique," Journal of Economic Surveys, Wiley Blackwell, vol. 14(1), pages 53-68, February.
    4. Qais Alemi & Carl Stempel & Patrick Marius Koga & Valerie Smith & Didem Danis & Kelly Baek & Susanne Montgomery, 2017. "Determinants of Health Care Services Utilization among First Generation Afghan Migrants in Istanbul," IJERPH, MDPI, vol. 14(2), pages 1-12, February.
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    1. Jiaoli Cai & Li Zhang & Denise Guerriere & Hongli Fan & Peter C. Coyte, 2020. "Where Do Cancer Patients in Receipt of Home-Based Palliative Care Prefer to Die and What Are the Determinants of a Preference for a Home Death?," IJERPH, MDPI, vol. 18(1), pages 1-11, December.

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