A SPATIAL PALLIATIVE VULNERABILITY INDEX CALCULATION FOR ASSESSING POPULATION NEED FOR PALLIATIVE CARE SERVICES
By mid-century it is projected that a significant proportion of western populations will be over the age of 65. As the population ages, there is mounting pressure to ensure that the health care system can address the needs of seniors, including those for end of life care—yet less than 20% of adults have access to formal palliative care services. With a growing recognition that development of palliative care service capacity needs to be prioritized comes a call to better understand the populations in greatest need for these services. This paper describes the development and testing of the Palliative Vulnerability Index (PVIX), an instrument designed to enable the spatial identification of population-level need for end of life care. PVIX is a means of selecting small, relatively homogenous areas that are most likely to require augmented palliative care services - based on demographic and social attributes commonly found to be associated with palliative care service users.
Method(s):
Building on the existing Vancouver Area Deprivation Index (VANDIX) methodology, PVIX was designed to provide a high-resolution spatial delineation of areas with high requirements for end of life services. Identifying variables specifically associated with heightened need for palliative care services—age, sex, living arrangement, and socio-economic status—enabled the creation of a high-resolution instrument to identify communities that should be prioritized for increased service capacity.
Result(s):
Comparison of the PVIX to the more general VANDIX across all census dissemination areas in British Columbia, Canada revealed that identification and application of key variables in PVIX resulted in a more precise and targeted spatial delineation of palliative care vulnerability than consideration of socio-economic status alone, or with age.
Conclusion(s):
Being able to spatially assess vulnerability for palliative care services can provide critical data for decision makers charged with rationalizing service allocation in terms of both service location and overall capacity. This method is generalizable to populations in both North America, Europe and Asia.