%0 Journal Article
%T Inequity in the provision of and access to palliative care for cancer patients. Results from the Italian survey of the dying of cancer (ISDOC)
%A Monica Beccaro
%A Massimo Costantini
%A Domenico Merlo
%A the ISDOC Study Group
%J BMC Public Health
%D 2007
%I BioMed Central
%R 10.1186/1471-2458-7-66
%X This is a mortality follow-back survey of 2,000 cancer deaths identified with a 2-stage probability sample, representative of the whole country. Information on patients' experience was gathered from the non-professional caregiver through an interview, using an adapted version of the VOICES questionnaire. A section of the interview concerned the places of care and the palliative care services provided to patients. Multivariate logistic regression analyses were conducted to identify the determinants of palliative care service use.Valid interviews were obtained for 67% of the identified caregivers (n = 1,271). Most Italian cancer patients were cared for at home (91%) or in hospital (63%), but with substantial differences within the country. Only 14% of Italian cancer patients cared for at home against 20% of those admitted to hospital, received palliative care support. The principal determinants identified for receiving these service were: an extended interval between diagnosis and death (P = 0.01) and the caregiver's high educational level (P = 0.01) for patients at home; the low patient's age (P < 0.01) and the caregiver's high educational level (P = 0.01) for patients in hospital.In Italy palliative care services are not equally available across the country. Moreover, access to the palliative care services is strongly associated with socio demographic characteristics of the patients and their caregivers. Italian Policy-makers need to equalise palliative care provision and access across the country to meet the needs of all cancer patients.The provision of palliative care services and programs for terminal ill patients has become an important public health issue during recent decades. The worldwide development of hospices and the growing number of hospital and domiciliary palliative care teams (PCTs) differ between countries, reflecting the heterogeneity of the health care systems, patient's needs, and cultures [1-3]. Recent studies show that a remarkable geographic v
%U http://www.biomedcentral.com/1471-2458/7/66