Abstract
BackgroundEfforts to tackle socioeconomic inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities. Most research on this topic examines differences in receipt of care. There is a need, particularly in the UK, for theoretically driven research that considers both receipt of care and the wider factors influencing the relationship between socioeconomic position and access to palliative and end-of-life care.MethodsThis is a mixed studies narrative synthesis on socioeconomic position and access to palliative and end-of-life care in the UK. Study searches were conducted in databases AMED, Medline, Embase, CINAHL, SocIndex, and Academic Literature Search, as well as grey literature sources, in July 2020. The candidacy model of access, which describes access as a seven-stage negotiation between patients and providers, guided study searches and provided a theoretical lens through which data were synthesised.ResultsSearches retrieved 5303 studies (after de-duplication), 29 of which were included. The synthesis generated four overarching themes, within which concepts of candidacy were evident: identifying needs; taking action; local conditions; and receiving care.ConclusionThere is not a consistent or clear narrative regarding the relationship between socioeconomic position and receipt of palliative and end-of-life care in the UK. Attempts to address any inequities in access will require knowledge and action across many different areas. Key evidence gaps in the UK literature concern the relationship between socioeconomic position, organisational context, and assessing need for care.
Highlights
Efforts to tackle socioeconomic inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities
Search terms were developed with reference to Cochrane guidance on finding palliative care literature [31] and the original literature synthesis that generated the candidacy model of access [16]
The review findings did not suggest a consistent or clear narrative regarding the relationship between socioeconomic position and receipt of specialist palliative care in the UK, with many studies finding no evidence of differences in receipt of care between socioeconomic groups
Summary
Efforts to tackle socioeconomic inequities in access to palliative and end-of-life care require comprehensive understanding about the extent of and reasons for inequities. Most research on this topic examines differences in receipt of care. There is a need, in the UK, for theoretically driven research that considers both receipt of care and the wider factors influencing the relationship between socioeconomic position and access to palliative and end-of-life care. French et al BMC Palliative Care 2021, 20(1):179 is not sufficient on its own to overcome these differences, fair access across socioeconomic groups is a vital component of an equitable healthcare system, facilitating opportunities to improve health outcomes [6]. Despite being critical to understanding whether receipt of care is inequitable, fewer studies have explored the relationship between socioeconomic position and these wider components of access
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