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Using Demographics to Predict Palliative Care Access in Inpatient Facilities in Rural North Carolina.

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The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
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Rural cancer patients face limited access to inpatient palliative care. Women, older adults, and rural residents are more likely to receive care at facilities without palliative care providers.

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access to carecanceroncologypalliative carerural health care

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Area of Science:

  • Oncology
  • Palliative Care
  • Rural Health

Background:

  • Palliative care significantly enhances quality of life, mood, and survival for cancer patients.
  • Rural populations often encounter substantial barriers to accessing palliative care services.
  • Limited data exists regarding inpatient cancer-related palliative care access in rural eastern North Carolina.

Purpose of the Study:

  • To describe access to inpatient palliative care for cancer patients in rural eastern North Carolina.
  • To develop a predictive model identifying patients likely to be admitted to facilities lacking palliative care.

Main Methods:

  • A descriptive, exploratory design analyzed demographic and clinical data from 2017-2018.
  • Data encompassed 8 hospitals within a regional teaching hospital system, including 7 rural facilities.
  • Binary logistic regression was employed to analyze inpatient admission patterns.

Main Results:

  • The study included 2,161 cancer patients (mean age 62.2 years; 49.4% female; 54% rural residents; 44.4% Black).
  • Rural hospitals without palliative care staff accounted for 388 admissions (18%).
  • Gender, county of residence, and age were significant predictors in the logistic model.

Conclusions:

  • Inpatient palliative care availability for cancer patients is notably limited.
  • Women, older individuals, and rural residents are disproportionately admitted to facilities without palliative care.
  • Younger males in urban counties have a higher predicted probability of admission to facilities with palliative care.