Table 5. Factors associated with use of palliative care provided by GPs and specialist palliative care services*.
| GP palliative care† | Specialist palliative care† | |||||
| Patient and health care characteristics | Received % (n) | OR (95% CI) | Received % (n) | OR (95% CI) | ||
| Belgium‖‖ | N = 1573 | N = 1512 | ||||
| Age | p = .872 | p = .397 | ||||
| ≥85 y | 54 (329) | Ref | 42 (251) | Ref | ||
| 65–84 y | 47 (349) | 0.96 (0.73 to 1.27) | 47 (339) | 1.16 (0.89 to 1.51) | ||
| 18–64 y | 52 (112) | 0.90 (0.59 to 1.36) | 56 (114) | 1.28 (0.85 to 1.92) | ||
| Sex | p = .435 | p = .297 | ||||
| Male | 46 (331) | Ref | 45 (307) | Ref | ||
| Female | 54 (459) | 1.11 (0.86 to 1.43) | 48 (397) | 1.14 (0.89 to 1.46) | ||
| Cause of death | p<.001 | p<.001 | ||||
| Non-cancer | 43 (424) | Ref | 36 (342) | Ref | ||
| Cancer | 63 (366) | 4.60 (3.37 to 6.28) | 65 (362) | 2.93 (2.24 to 3.85) | ||
| Place of death | p<.001 | p<.001 | ||||
| Home | 77 (276) | Ref | 48 (172) | Ref | ||
| Care home | 69 (338) | 1.06 (0.75 to 1.48) | 50 (242) | 1.72 (1.26 to 2.36) | ||
| Hospital | 19 (108) | 0.07 (0.05 to 0.10) | 27 (142) | 0.48 (0.36 to 0.65) | ||
| Palliative care unit/hospice | 46 (68) | 0.14 (0.09 to 0.23) | 100 (148) | § | ||
| Other‡ | 0 (0) | 0 (0) | ||||
| Netherlands‖‖ | N = 599 | N = 585 | ||||
| Age | p = .942 | p = .383 | ||||
| ≥85 y | 60 (110) | Ref | 22 (40) | Ref | ||
| 65–84 y | 62 (189) | 0.98 (0.59 to 1.64) | 32 (94) | 1.50 (0.84 to 2.68) | ||
| 18–64 y | 66 (72) | 1.09 (0.54 to 2.20) | 33 (35) | 1.33 (0.62 to 2.83) | ||
| Sex | p = .064 | p = .629 | ||||
| Male | 61 (176) | Ref | 32 (86) | Ref | ||
| Female | 63 (195) | 1.51 (0.98 to 2.33) | 27 (83) | 1.12 (0.71 to 1.78) | ||
| Cause of death | p<.001 | p = .477 | ||||
| Non-cancer | 47 (129) | Ref | 19 (51) | Ref | ||
| Cancer | 75 (242) | 2.44 (1.51 to 3.93) | 37 (118) | 1.22 (0.71 to 2.08) | ||
| Place of death | p<.001 | p = .001 | ||||
| Home | 87 (228) | Ref | 27 (69) | Ref | ||
| Care home | 67 (71) | 0.40 (0.22 to 0.73) | 20 (22) | 0.81 (0.44 to 1.49) | ||
| Hospital | 20 (33) | 0.04 (0.03 to 0.08) | 8 (13) | 0.25 (0.13 to 0.49) | ||
| Palliative care unit/hospice | 61 (39) | 0.21 (0.11 to 0.39) | 100 (65) | § | ||
| Other‡ | 0 (0) | 0 (0) | ||||
| Italy‖‖ | N = 1777 | N = 1709 | ||||
| Age | p = .062 | p = .001 | ||||
| ≥85 y | 55 (389) | Ref | 25 (176) | Ref | ||
| 65–84 y | 56 (471) | 0.93 (0.74 to 1.16) | 45 (356) | 1.46 (1.12 to 1.89) | ||
| 18–64 y | 53 (119) | 0.67 (0.47 to 0.94) | 64 (140) | 2.02 (1.38 to 2.97) | ||
| Sex | p = .433 | p = .476 | ||||
| Male | 55 (459) | Ref | 42 (341) | Ref | ||
| Female | 55 (520) | 1.08 (0.89 to 1.32) | 37 (331) | 1.09 (0.86 to 1.37) | ||
| Cause of death | p<.001 | p<.001 | ||||
| Non-cancer | 48 (462) | Ref | 19 (174) | Ref | ||
| Cancer | 63 (517) | 1.95 (1.57 to 2.43) | 63 (498) | 5.19 (4.07 to 6.62) | ||
| Place of death | p<.001 | p = .473 | ||||
| Home | 63 (515) | Ref | 35 (277) | Ref | ||
| Care home | 48 (75) | 0.59 (0.42 to 0.83) | 31 (45) | 1.34 (0.88 to 2.04) | ||
| Hospital | 47 (324) | 0.53 (0.43 to 0.65) | 38 (249) | 1.15 (0.90 to 1.46) | ||
| Palliative care unit/hospice | 64 (65) | 0.85 (0.54 to 1.32) | 100 (101) | § | ||
| Other‡ | 0 (0) | 0(0) | ||||
| GP palliative care | Specialist palliative care | |||||
| Patient and health care characteristics | Received n (%) | OR (95% CI) | Received n (%) | OR (95% CI) | ||
| Spain‖‖ | N = 357 | N = 378 | ||||
| Age | p = .952 | p<.001 | ||||
| ≥85 y | 64 (98) | Ref | 29 (47) | Ref | ||
| 65–84 y | 66 (107) | 1.06 (0.63 to 1.79) | 54 (92) | 2.47 (1.49 to 4.12) | ||
| 18–64 y | 70 (28) | 1.15 (0.47 to 2.82) | 73 (30) | 5.52 (2.29 to 13.33) | ||
| Sex | p = .363 | p = .465 | ||||
| Male | 63 (123) | Ref | 47 (95) | Ref | ||
| Female | 68 (110) | 1.25 (0.78 to 2.01) | 43 (74) | 1.19 (0.75 to 1.90) | ||
| Cause of death | p = .008 | p = .004 | ||||
| Non-cancer | 59 (128) | Ref | 34 (78) | Ref | ||
| Cancer | 76 (105) | 2.12 (1.22 to 3.70) | 62 (91) | 2.08 (1.26 to 3.44) | ||
| Place of death | p<.001 | p = .145 | ||||
| Home | 78 (139) | Ref | 42 (79) | Ref | ||
| Care home | 52 (23) | 0.37 (0.18 to 0.75) | 47 (21) | 1.80 (0.90 to 3.60) | ||
| Hospital | 51 (61) | 0.29 (0.17 to 0.49) | 41 (52) | 0.75 (0.45 to 1.25) | ||
| Palliative care unit/hospice | 67 (10) | 0.42 (0.13 to 1.36) | 100 (17) | § | ||
| Other‡ | 0 (0) | 0 (0) | ||||
OR = odds ratio; CI = confidence interval; Ref = reference category.
All percentages indicate proportions within the independent variable. Percentages are rounded and thus may not add up to 100.
Missing values for dependent variables: specialist palliative care n = 191 (4.3%); GP palliative care n = 55 (1.2%); missing values for independent variables: age n = 12 (0.3%), sex n = 12 (0.3%), cause of death n = 53 (1.2%), place of death n = 15 (0.3%).
Odds ratios in bold indicate statistically significant associations.
Independent variables age and cause of death were correlated (r = .40, p<.01). Variance inflation factors did not indicate problems of multicollinearity.
Two multivariate logistic regression analyses with 1) palliative care by the GP and 2) specialist palliative care as dependent variable.
Specialist palliative care and palliative care by the GP are not mutually exclusive categories.
Not included in significance tests.
OR not meaningful as 100% of cases have the same value on the dependent variable.
Missing values on the independent variables resulted in missing cases in the multivariate logistic regression analyses. The number of deaths included in the analyses are indicated.