Association between sociodemographic, illness-related and service-related factors with three outcome measures for acute end-of-life care in the last 3 months of life
| 3 or more EHA last 3 months | 1 or more EHA last month | 1 or more ED last 2 weeks | ||||||||||
| n=3472 | n=3441 | n=3441 | ||||||||||
| Univariate | Multivariate | Univariate | Multivariate | Univariate | Multivariate | |||||||
| RR | 95% CI | RR | 95% CI | RR | 95% CI | RR | 95% CI | RR | 95% CI | RR | 95% CI | |
| Age | 0.98 | (0.97 to 0.99) | 0.98 | (0.97 to 0.99) | 0.99 | (0.99 to 0.10) | 0.99 | (0.99 to 1.00) | 0.99 | (0.99 to 1.00) | 0.99 | (0.99 to 1.00) |
| Gender (ref. female) | ||||||||||||
| Male | 1.15 | (0.97 to 1.36) | 1.10 | (0.92 to 1.31) | 1.10 | (1.02 to 1.20) | 1.11 | (1.02 to 1.20) | 1.09 | (0.98 to 1.21) | 1.10 | (0.98 to 1.23) |
| IMD quintile (ref. 1, most deprived) | ||||||||||||
| 2 | 0.79 | (0.63 to 0.99) | 0.82 | (0.65 to 1.03) | 1.00 | (0.90 to 1.12) | 1.01 | (0.91 to 1.12) | 0.97 | (0.84 to 1.11) | 1.01 | (0.89 to 1.15) |
| 3 | 0.80 | (0.62 to 1.02) | 0.88 | (0.70 to 1.12) | 1.01 | (0.90 to 1.13) | 1.03 | (0.92 to 1.15) | 0.90 | (0.77 to 1.06) | 0.93 | (0.80 to 1.15) |
| 4 | 0.82 | (0.62 to 1.08) | 0.96 | (0.75 to 1.24) | 0.92 | (0.81 to 1.05) | 0.96 | (0.85 to 1.09) | 0.95 | (0.80 to 1.13) | 1.00 | (0.84 to 1.18) |
| 5 | 0.68 | (0.49 to 0.93) | 0.95 | (0.68 to 1.31) | 0.97 | (0.81 to 1.16) | 1.06 | (0.90 to 1.25) | 0.88 | (0.71 to 1.10) | 0.98 | (0.79 to 1.22) |
| Lived in care home (ref. no) | 0.43 | (0.24 to 0.78) | 0.53 | (0.28 to 0.98) | 0.54 | (0.41 to 0.72) | 0.54 | (0.41 to 0.72) | 0.71 | (0.51 to 0.99) | 0.70 | (0.49 to 0.99) |
| Type of cancer (ref. bowel) | ||||||||||||
| Lung | 1.53 | (1.13 to 2.06) | 1.60 | (1.16 to 2.20) | 1.11 | (0.98 to 1.25) | 1.08 | (0.96 to 2.23) | 1.04 | (0.88 to 1.22) | 1.01 | (0.85 to 1.19) |
| Prostate | 1.57 | (1.09 to 2.28) | 1.57 | (1.07 to 2.30) | 1.03 | (0.89 to 1.21) | 0.98 | (0.84 to 2.15) | 0.91 | (0.74 to 1.11) | 0.89 | (0.72 to 1.10) |
| Breast | 1.32 | (0.88 to 1.97) | 1.24 | (0.82 to 1.87) | 1.15 | (0.98 to 1.34) | 1.19 | (1.02 to 1.39) | 1.11 | (0.93 to 1.34) | 1.16 | (0.94 to 1.42) |
| Pancreas | 1.34 | (0.88 to 2.04) | 1.23 | (0.93 to 2.08) | 1.05 | (0.89 to 1.25) | 1.02 | (0.87 to 2.20) | 0.85 | (0.67 to 1.09) | 0.82 | (0.63 to 1.06) |
| Haematological | 1.63 | (1.01 to 2.61) | 1.23 | (0.73 to 2.07) | 1.03 | (0.83 to 1.29) | 0.91 | (0.72 to 2.15) | 0.98 | (0.74 to 1.31) | 0.93 | (0.68 to 1.26) |
| Other | 1.24 | (0.91 to 1.69) | 1.15 | (0.83 to 1.58) | 1.00 | (0.88 to 1.12) | 0.96 | (0.86 to 1.08) | 0.85 | (0.73 to 0.99) | 0.82 | (0.70 to 0.96) |
| Number QoF comorbidities (ref. 0) | ||||||||||||
| 1 | 0.81 | (0.64 to 1.03) | 0.88 | (0.69 to 1.11) | 0.90 | (0.81 to 1.00) | 0.92 | (0.83 to 1.02) | 0.82 | (0.70 to 0.96) | 0.88 | (0.75 to 1.04) |
| 2 | 0.83 | (0.65 to 1.07) | 0.99 | (0.76 to 1.30) | 0.99 | (0.89 to 1.10) | 1.06 | (0.95 to 1.18) | 0.95 | (0.81 to 1.11) | 1.05 | (0.89 to 1.25) |
| 3 | 1.01 | (0.79 to 1.29) | 1.23 | (0.94 to 1.62) | 0.92 | (0.82 to 1.04) | 0.99 | (0.87 to 1.12) | 0.93 | (0.79 to 1.10) | 1.01 | (0.84 to 1.21) |
| ≥4 | 0.80 | (0.62 to 1.04) | 0.98 | (0.74 to 1.30) | 1.04 | (0.92 to 1.17) | 1.11 | (0.97 to 1.27) | 1.01 | (0.86 to 1.18) | 1.09 | (0.89 to 1.32) |
| QoF comorbidities (ref. no) | ||||||||||||
| COPD | 1.09 | (0.88 to 1.34) | * | * | 1.11 | (1.01 to 1.23) | 1.07 | (0.97 to 1.19) | 1.05 | (0.91 to 1.21) | * | * |
| Depression | 1.01 | (0.84 to 1.22) | * | * | 1.04 | (0.94 to 1.14) | * | * | 0.98 | (0.86 to 1.11) | * | * |
| Diabetes | 1.02 | (0.86 to 1.22) | * | * | 1.04 | (0.97 to 1.12) | * | * | 1.09 | (0.97 to 1.22) | * | * |
| Hypertension | 0.92 | (0.79 to 1.07) | * | * | 0.98 | (0.92 to 1.05) | * | * | 0.96 | (0.87 to 1.07) | * | * |
| Dementia | 0.62 | (0.44 to 0.88) | 0.78 | (0.54 to 1.14) | 0.84 | (0.73 to 0.97) | 0.94 | (0.82 to 1.07) | 0.86 | (0.70 to 1.06) | * | * |
| CHD | 0.99 | (0.82 to 1.20) | * | * | 1.08 | (0.99 to 1.18) | * | * | 1.16 | (1.03 to 1.30) | 1.14 | (0.99 to 1.31) |
| Contacts with GP practice (ref. 0–3) | ||||||||||||
| 4–10 | 1.21 | (1.01 to 1.46) | 1.18 | (0.98 to 1.41) | 1.05 | (0.97 to 1.13) | * | * | 1.12 | (1.00 to 1.24) | 1.10 | (0.98 to 1.22) |
| ≥11 | 1.59 | (1.29 to 1.95) | 1.63 | (1.33 to 1.99) | 1.08 | (0.98 to 1.19) | * | * | 1.19 | (1.03 to 1.38) | 1.27 | (1.10 to 1.47) |
| Contacts with community nurses (ref. 0–3) | ||||||||||||
| 4–12 | 1.08 | (0.90 to 1.29) | * | * | 1.04 | (0.96 to 1.13) | 1.06 | (0.98 to 1.15) | 0.97 | (0.86 to 1.10) | 0.96 | (0.85 to 1.08) |
| ≥13 | 1.01 | (0.83 to 1.24) | * | * | 0.84 | (0.76 to 0.93) | 0.88 | (0.90 to 0.98) | 0.80 | (0.69 to 0.93) | 0.79 | (0.68 to 0.92) |
| Contacts with community palliative care teams (ref. 0–3) | ||||||||||||
| 4–8 | 0.88 | (0.68 to 1.15) | * | * | 0.91 | (0.80 to 1.04) | 0.95 | (0.82 to 1.08) | 0.97 | (0.82 to 1.14) | 1.01 | (0.85 to 1.21) |
| ≥9 | 0.93 | (0.62 to 1.37) | * | * | 0.78 | (0.63 to 0.96) | 0.85 | (0.69 to 1.04) | 0.70 | (0.50 to 0.97) | 0.78 | (0.56 to 1.08) |
| Contacts with rehabilitation teams (ref. 0) | ||||||||||||
| 1–3 | 1.01 | (0.73 to 1.38) | * | * | 0.89 | (0.76 to 1.05) | * | * | 1.01 | (0.82 to 1.25) | * | * |
| ≥4 | 0.93 | (0.55 to 1.58) | * | * | 0.80 | (0.61 to 1.04) | * | * | 0.81 | (0.57 to 1.15) | * | * |
| Days in hospital | 0.94 | (0.94 to 0.95) | 1.04 | (1.03 to 1.04) | 1.02 | (1.01 to 1.02) | 1.02 | (1.01 to 1.02) | 1.00 | (0.99 to 1.00) | 1.00 | (1.00 to 1.01) |
*Variable not included in the model.
CHD, chronic heart disease; COPD, chronic obstructive pulmonary disease; ED, emergency department visit; EHA, emergency hospital admissions; IMD, Index of Multiple Deprivation; QoF, quality of outcomes framework; RR, risk ratio.