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Disparities in care at the end of life

The latest PhD thesis from DCE explores how underlying diseases and socioeconomic position impact care at the end of life.

Anne Høy Seemann Vestergaard, who recently defended her PhD thesis, has conducted three studies exploring the role of underlying disease and socioeconomic position for disparities in care at the end of life.

Using data from national registries, Anne and colleagues examined end-of-life illness trajectories as reflected by healthcare utilisation (Study I), socioeconomic disparity trends over time in use of healthcare services at the end of life (Study II), and healthcare costs at the end of life (Study III).

The studies suggested that although illness trajectories as reflected in healthcare utilisation patterns seemed comparable, substantial disparities were observed in care at the end of life according to the disease causing death. Even within a tax-financed healthcare system, patients dying from non-cancer diseases incurred considerably lower healthcare costs at the end of life than patients with cancer, including limited costs and utilisation of specialist palliative care. Furthermore, socioeconomic position has been increasingly associated with the access to specialist palliative care over the years, favouring patients with a high socioeconomic position.