Are Cancer Patients’ Socioeconomic and Cultural Factors Associated with Contact to General Practitioners in the Last Phase of Life?
Table 2
Associations between ≥2 GP face-to-face contacts (including in-office consultations and home visits) and home visits in the last 90 days of life and patient-related socioeconomic and cultural characteristics for those 584 patients, who had a full dataset. The unadjusted prevalence ratios (PRs) and the adjusted PRs for the full model are shown with 95% confidence intervals (95% CIs). The full model includes all variables in the table adjusted for gender, age (continuous variable), primary cancer diagnosis, number of days at hospital (continuous variable), place of death, and involvement of palliative specialist team.
GP face-to-face contacts
Home visits by the GP
(≤1 contact/≥2 contacts)
(No/yes)
Unadjusted prevalence ratio (95% CI)
value
Adjusted prevalence ratio (95% CI)
value
Unadjusted prevalence ratio (95% CI)
value
Adjusted prevalence ratio (95% CI)
value
Variables in final model
Patient’s marital status
Single
1
1
1
1
Married or cohabiting
0.99 (0.92; 1.07)
0.837
1.05 (0.97; 1.14)
0.189
0.90 (0.83; 0.98)
0.018
0.97 (0.90; 1.06)
0.525
Having children living at home
No
1
1
1
1
Yes
0.73 (0.55; 0.96)
0.024
0.83 (0.63; 1.09)
0.177
0.69 (0.50; 0.94)
0.019
1.08 (0.78; 1.48)
0.651
Patient’s economic status
High income (>20000 £/year)
1
1
1
1
Medium income (10001–20000 £/year)
1.12 (1.03; 1.23)
0.009
1.04 (0.96; 1.14)
0.329
1.23 (1.11; 1.36)
0.000
1.09 (0.99; 1.19)
0.071
Low income (0–10000 £/year)
1.24 (1.11; 1.39)
0.000
1.18 (1.03; 1.35)
0.017
1.17 (0.97; 1.41)
0.106
1.18 (0.98; 1.42)
0.074
Employment
Unemployed, social security, student
1
1
Old age or early retirement pensioner
1.06 (0.95; 1.19)
0.283
Not included because of collinearity with income
1.30 (1.11; 1.52)
0.001
Not included because of collinearity with income
Employed or leadership position
0.83 (0.70; 0.99)
0.038
0.78 (0.61; 0.99)
0.042
Ethnicity
Not immigrant or descendant
1
1
1
1
Immigrant or descendant
1.10 (0.96; 1.28)
0.175
1.17 (1.02; 1.35)
0.025
0.72 (0.50; 1.05)
0.090
0.78 (0.55; 1.12)
0.183
Urbanicity, inhabitants in municipality
10,000 inhabitants
1
1
1
1
10,000–49,999 inhabitants
0.97 (0.88; 1.06)
0.522
0.97 (0.89; 1.07)
0.576
0.97 (0.87; 1.09)
0.633
1.00 (0.90; 1.12)
0.939
50,000–99,999 inhabitants
0.94 (0.84; 1.04)
0.215
0.92 (0.83; 1.01)
0.095
0.91 (0.80; 1.04)
0.172
0.90 (0.80; 1.02)
0.115
≥100,000 inhabitants
0.84 (0.76; 0.93)
0.001
0.85 (0.77; 0.95)
0.003
0.86(0.77; 0.96)
0.008
0.89 (0.80; 0.99)
0.037
The final model was adjusted for the following variables
Gender of patient
Male
1
1
1
1
Female
1.00 (0.92; 1.07)
0.917
0.98 (0.90; 1.07)
0.635
1.02 (0.93; 1.11)
0.719
0.96 (0.87; 1.06)
0.461
Age of patient (continuous variable)
1.01 (1.00; 1.01)
0.000
1.00 (1.00; 1.01)
0.020
1.01 (1.01; 1.02)
0.000
1.01 (1.01; 1.02)
0.000
Primary cancer diagnosis
Bronchus/lung
1
1
1
1
Colon/rectum
0.91 (0.81; 1.02)
0.117
0.91 (0.82; 1.02)
0.124
0.87 (0.75; 1.00)
0.056
0.83 (0.73; 0.95)
0.008
Prostate
0.90 (0.79; 1.02)
0.086
0.85 (0.74; 0.96)
0.010
1.05 (0.94; 1.17)
0.385
0.94 (0.84; 1.05)
0.276
Breast
0.89 (0.77; 1.02)
0.088
0.91 (0.79; 1.04)
0.158
0.83 (0.69; 0.98)
0.032
0.86 (0.71; 1.03)
0.109
Other
0.88 (0.81; 0.97)
0.006
0.90 (0.81; 0.99)
0.031
0.87 (0.78; 0.96)
0.009
0.88 (0.79; 0.97)
0.010
Days spent at hospital in the last 90 days of the patient’s life (continuous variable)
0.99 (0.99; 1.00)
0.000
0.99 (0.99; 1.00)
0.011
0.99 (0.99; 1.00)
0.000
1.00 (0.99; 1.00)
0.199
Place of death
Institutional death (Hospital/hospice)
1
1
1
1
Home/nursing home death
1.28 (1.17; 1.39)
0.000
1.19 (1.09; 1.29)
0.000
1.47 (1.33; 2.63)
0.000
1.33 (1.21; 1.47)
0.000
Involvement of a specialist team
Yes
1
1
1
1
No
1.05 (0.98; 1.13)
0.189
1.06 (0.99; 1.14)
0.105
1.04 (0.95; 1.13)
0.384
1.10 (1.01; 1.20)
0.029
GP: general practitioner. £: English Pounds. Note: significant correlations with a value < 0.05 are in bold text.
