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Disparities In Cancer Care And Costs At The End Of Life: Evidence From England's National Health Service

Walsh, B. & Laudicella, M. (2017). Disparities In Cancer Care And Costs At The End Of Life: Evidence From England's National Health Service. Health Affairs, 36(7), pp. 1218-1226. doi: 10.1377/hlthaff.2017.0167


In universal health care systems such as the English National Health Service, equality of access is a core principle, and health care is free at the point of delivery. However, even within a universal system, disparities in care and costs exist along a socioeconomic gradient. Little is known about socioeconomic disparities at the end of life and how they affect health care costs. This study examines disparities in end-of-life treatment costs for cancer patients in England. Analyzing data on over 250,000 colorectal, breast, prostate, and lung cancer patients from multiple national databases, we found evidence illustrating that disparities are driven largely by the greater use of emergency inpatient care among patients of lower socioeconomic status. Even within a system with free health care, differences in the use of care create disparities in cancer costs. While further studies of these barriers is required, our research suggests that disparities may be reduced through better management of needs through the use of less expensive and more effective health care settings and treatments.

Publication Type: Article
Publisher Keywords: Cancer, Costs, End of Life, National Health Service
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
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