Does place of death from cancer vary between ethnic groups in South East England?

Abstract

There is growing evidence that the palliative care needs of certain people, such as those from minority ethnic groups, are not being met. The aim of this study was to investigate whether place of death from cancer differs between ethnic groups. A total of 101,516 patients resident in South East England and who died from lung, colorectal, breast or prostate cancer between 1998 and 2006 were extracted from the Thames Cancer Registry database. Ethnicity data were available for 68,804 patients (68%). The odds ratios (ORs) of death from cancer in a hospice, at home or in hospital were calculated. The results were adjusted for age at death, deprivation, cancer network of residence and time between diagnosis and death. Following adjustment, death in a hospice was significantly less likely for Pakistani patients (OR=0.47 95% CI [0.30-0.74]), Indian patients (0.68 [0.55-0.84]) and Bangladeshi patients (0.33 [0.19-0.56]). Death at home was significantly less likely in Black African patients (0.48 [0.36-0.65]), Black Caribbean patients (0.78 [0.67-0.90]) and Chinese patients (0.46 [0.28-0.76]). Pakistani, Indian, Bangladeshi, Black African, Black Caribbean and Chinese patients were all significantly more likely than White patients to die in hospital. The results were not substantially altered by recoding the unknown ethnicity group to White or using multiple imputation to assign those with a missing ethnicity an ethnic group. Place of death varies between ethnic groups. This may reflect differences in preferences for place of death or barriers to accessing specialist care in different settings. More detailed prospective qualitative studies are urgently required to determine reasons for this variation.

Dying at home – is it better: A narrative appraisal of the state of the science

“…Pakistani, Indian, Bangladeshi, Black African, Black Caribbean and Chinese patients were all significantly more likely than White patients to die in hospital. 43 People living in metropolitan areas are less likely to die at home. 44,45 The relationship between age and place of death is more complex.…”

Servicing Multi‐cultural Needs at the End of Life

“…Ethnic minority health is increasingly recognised as a crucial 'tracer' for measuring the success in achieving health and patient-preferred outcomes for the population in general (Department of Health 1997), and palliative care/end-of-life care in particular (Koffman et al 2007;Coupland et al 2011;Evans et al 2011) where there is growing evidence that we are not all equal in life and in death. The National End-of-Life Care Strategy in the UK recognises that although much has been achieved in the last few years, there is still much to be done in order to address inequities in the care provided at the end of life (Department of Health 2012).…”

Psychiatric comorbidity among terminally ill patients in general practice in the Netherlands: a comparison between patients with cancer and heart failure

“…As most patients with cancer die at home, GPs also coordinate the palliative care for these patients and their families in their final phase of life. [4][5][6][7][8] Previous research demonstrated that GPs in the Netherlands provide palliative care to, on average, four patients with cancer per year. 9 The growing number of patients with cancer will further increase the palliative care workload in general practice in the future.…”