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Does ethnicity affect primary palliative care identification and coding? An observational retrospective cohort study
Gemma Clarke1, Farag Shuweihdi2, Samuel D Relton3
1St Gemma's Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK g.c.clarke@leeds.ac.uk.
Summary
This study found no significant link between ethnicity and primary palliative care identification. However, ethnic minority patients experienced differences in survival and initial palliative care coding, highlighting a need for equitable access monitoring.
Area of Science:
- Palliative Care Research
- Health Equity
- Primary Care Medicine
Background:
- Primary palliative care integrates symptom management into standard primary care for life-limiting illnesses.
- Early identification of patient needs is crucial but under-researched concerning ethnic disparities.
- Limited data exists on ethnicity's impact on primary palliative care identification and coding.
Purpose of the Study:
- To investigate the associations between patient ethnicity and the identification and coding of primary palliative care.
- To analyze survival differences and the timing of palliative care initiation across ethnic groups.
Main Methods:
- Retrospective cohort study utilizing anonymised primary care data from deceased patients in England.
- Multilevel logistic regression and Cox regression models were employed to analyze identification and survival.
- Chi-squared tests assessed differences in initial palliative care coding.
Main Results:
- No statistically significant association was found between ethnicity and primary palliative care identification after adjusting for covariates.
- Patients from Asian and Black, African, Caribbean groups had significantly longer survival compared to White groups.
- Patients from 'Other' ethnic groups had significantly shorter survival, and ethnic minorities were more likely to have specialist palliative care records initiated.
Conclusions:
- While ethnicity did not affect primary palliative care identification, survival and care initiation patterns varied significantly.
- Ensuring equitable access to palliative care requires continuous improvement in identification processes and data quality audits.
- Further research and monitoring are essential to address observed disparities in palliative care experiences.
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