Inpatient Hospice Access in the United Kingdom: A Spatial Provision Analysis

Area of Science:

• Healthcare access research
• Spatial analysis in public health
• Palliative care service evaluation

Background:

• Equitable access to inpatient hospice care is crucial for end-of-life support.
• Previous assessments of hospice accessibility in the UK have been limited in scope.
• Understanding spatial access is key to identifying and addressing healthcare inequities.

Purpose of the Study:

• To conduct a comprehensive spatial analysis of inpatient hospice unit accessibility across the United Kingdom.
• To evaluate travel times and population coverage for hospice services at national and subnational levels.
• To identify regional variations in access to palliative care.

Main Methods:

• A UK-wide, population-based spatial analysis was performed.
• Motorised travel times to the nearest inpatient hospice unit were calculated.
• Population coverage was assessed using 30, 60, and 120-minute travel time thresholds.

Main Results:

• Median travel times to hospices varied significantly by nation (e.g., 16.4 min in England vs. 70.4 min in Scotland).
• Within a 30-minute travel time, 97.6% of England's population had access, compared to 68.5% in Northern Ireland.
• Even at a 60-minute threshold, substantial populations in Scotland and Northern Ireland remained without access.

Conclusions:

• This study is the first national spatial analysis of inpatient hospice access in the UK.
• Persistent regional inequities in geographic access to hospice care were identified.
• Spatial accessibility analysis is vital for informing equitable service planning, policy, and future research in palliative care.