{Reference Type}: Journal Article
{Title}: Survival Time Disparities after Palliative Care Use Among Low-Income Patients on Social Welfare Programs: A Retrospective Cohort Study.
{Author}: Nishioka D;Kanzaki I;Kihara A;
{Journal}: Palliat Med Rep
{Volume}: 5
{Issue}: 1
{Year}: 2024
暂无{DOI}: 10.1089/pmr.2023.0077
{Abstract}: <B>UNASSIGNED: </B>Relieving the total pain of patients with cancer and supporting their well-being throughout their lives are important roles of palliative and supportive care. Poverty may inhibit patients from receiving dignified end-of-life care; however, using social welfare services may reduce its impact on patients' end-of-life experiences. Nevertheless, no study has investigated which social welfare service could lead to favorable end-of-life experiences for patients living in poverty.<BR><B>UNASSIGNED: </B>This study aimed to describe the characteristics of users of palliative care among low-income patients and examine the difference in survival time among patients with cancer on social welfare services in a single center in Kyoto, Japan.<BR><B>UNASSIGNED: </B>We conducted a retrospective cohort study.<BR><B>UNASSIGNED: </B>We included 220 patients using Public Assistance (PA: aid minimum income and medical/long-term care), Free/Low-Cost Medical Care (FLCMC: aid only medical care), and nonwelfare-users who newly received palliative care in 2021.<BR><B>UNASSIGNED: </B>We calculated patients' survival time from the initiation of palliative care to death. In addition, we identified patients who experienced home death.<BR><B>UNASSIGNED: </B>Compared with nonusers, FLCMC beneficiaries had shorter survival times (adjusted hazard ratio [aHR] 2.05, 95% confidence interval [CI] 0.80-5.22). No difference was observed among PA beneficiaries (aHR 1.19, 95% CI 0.49-2.87). No home death was observed among welfare service recipients.<BR><B>UNASSIGNED: </B>Social welfare benefits only for medical expenses may not sufficiently support dignified end-of-life care for low-income patients. Further studies are required to examine the robustness of this study considering various bio-psycho-social factors that can influence these findings, to support low-income patients with cancer on social welfare services.