Association of socioeconomic status with medical assistance in dying: a case–control analysis
| Autor: | Deva Thiruchelvam, Donald A. Redelmeier, Eldar Shafir, Kelvin Ng |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
cancer pain medicine.medical_specialty Palliative care Population Subgroup analysis 030204 cardiovascular system & hematology Social class adult palliative care primary care 03 medical and health sciences 0302 clinical medicine Health care medicine Humans rationing 030212 general & internal medicine education Socioeconomic status Health policy Ontario education.field_of_study Medical Assistance business.industry Palliative Care Case-control study health policy General Medicine 3. Good health Social Class Case-Control Studies Family medicine Medicine business |
| Zdroj: | BMJ Open, Vol 11, Iss 5 (2021) BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesEconomic constraints are a common explanation of why patients with low socioeconomic status tend to experience less access to medical care. We tested whether the decreased care extends to medical assistance in dying in a healthcare system with no direct economic constraints.DesignPopulation-based case–control study of adults who died.SettingOntario, Canada, between 1 June 2016 and 1 June 2019.PatientsPatients receiving palliative care under universal insurance with no user fees.ExposurePatient’s socioeconomic status identified using standardised quintiles.Main outcome measureWhether the patient received medical assistance in dying.ResultsA total of 50 096 palliative care patients died, of whom 920 received medical assistance in dying (cases) and 49 176 did not receive medical assistance in dying (controls). Medical assistance in dying was less frequent for patients with low socioeconomic status (166 of 11 008=1.5%) than for patients with high socioeconomic status (227 of 9277=2.4%). This equalled a 39% decreased odds of receiving medical assistance in dying associated with low socioeconomic status (OR=0.61, 95% CI 0.50 to 0.75, pConclusionsPatients with low socioeconomic status are less likely to receive medical assistance in dying under universal health insurance. An awareness of this imbalance may help in understanding patient decisions in less extreme clinical settings. |
| Databáze: | OpenAIRE |
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