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Examining gender differences in specialized palliative care: A retrospective cohort study of patients with cancer in Skåne, Sweden

Zere Goitom, Johanna LU (2025) MPHN40 20251
Social Medicine and Global Health
Abstract (Swedish)
Background: Gender differences in palliative care is an under-researched area, both internationally and in Sweden. A regional pilot study by our research group indicated that men have greater unmet palliative care needs prior to referral. Building on these findings, the aim of this study was to examine gender differences in the quality of care received at the end of life within specialized palliative care among adult patients with cancer in Skåne, Sweden.

Methods: This retrospective cohort study included two cohorts: a training cohort (n = 134), consisting of participants from the pilot study, and a validation cohort (n = 15,861). Data were obtained from the Swedish Palliative Care Registry, including patients with cancer enrolled in... (More)
Background: Gender differences in palliative care is an under-researched area, both internationally and in Sweden. A regional pilot study by our research group indicated that men have greater unmet palliative care needs prior to referral. Building on these findings, the aim of this study was to examine gender differences in the quality of care received at the end of life within specialized palliative care among adult patients with cancer in Skåne, Sweden.

Methods: This retrospective cohort study included two cohorts: a training cohort (n = 134), consisting of participants from the pilot study, and a validation cohort (n = 15,861). Data were obtained from the Swedish Palliative Care Registry, including patients with cancer enrolled in specialized palliative care and died between 2013 and 2023. Descriptive statistics, parametric and non-parametric tests, and regression analysis were performed to examine gender differences across quality indicators of palliative care, including place of death, end-of-life care planning, symptom assessment and management, and enrollment duration.

Results: No significant gender differences were found in serious illness conversations, symptom assessment, or symptom management in both cohorts. Men had significantly shorter enrollment periods compared to women (validation cohort, adjusted IRR 0.85, 95% CI: 0.82–0.88) and were more likely to die at home. Adjusted analyses of validation cohort showed that men had higher odds of having a preferred place of death conversation documented (adjusted OR 1.20, 95% CI: 1.06–1.37).

Conclusion: While serious illness conversation, symptom assessment and management were equitable within specialized palliative care, gender differences persisted in enrollment duration, place of death and preferred place of death conversation. These findings highlight the need to address earlier phases of the illness trajectory and integrate gender-sensitive approaches into public health efforts to promote equity in palliative care. (Less)
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author
Zere Goitom, Johanna LU
supervisor
organization
course
MPHN40 20251
year
type
H2 - Master's Degree (Two Years)
subject
keywords
Gender differences Palliative care End-of-life care
language
English
id
9212590
date added to LUP
2026-06-12 12:33:51
date last changed
2026-06-12 12:33:51
@misc{9212590,
  abstract     = {{Background: Gender differences in palliative care is an under-researched area, both internationally and in Sweden. A regional pilot study by our research group indicated that men have greater unmet palliative care needs prior to referral. Building on these findings, the aim of this study was to examine gender differences in the quality of care received at the end of life within specialized palliative care among adult patients with cancer in Skåne, Sweden.

Methods: This retrospective cohort study included two cohorts: a training cohort (n = 134), consisting of participants from the pilot study, and a validation cohort (n = 15,861). Data were obtained from the Swedish Palliative Care Registry, including patients with cancer enrolled in specialized palliative care and died between 2013 and 2023. Descriptive statistics, parametric and non-parametric tests, and regression analysis were performed to examine gender differences across quality indicators of palliative care, including place of death, end-of-life care planning, symptom assessment and management, and enrollment duration.

Results: No significant gender differences were found in serious illness conversations, symptom assessment, or symptom management in both cohorts. Men had significantly shorter enrollment periods compared to women (validation cohort, adjusted IRR 0.85, 95% CI: 0.82–0.88) and were more likely to die at home. Adjusted analyses of validation cohort showed that men had higher odds of having a preferred place of death conversation documented (adjusted OR 1.20, 95% CI: 1.06–1.37).

Conclusion: While serious illness conversation, symptom assessment and management were equitable within specialized palliative care, gender differences persisted in enrollment duration, place of death and preferred place of death conversation. These findings highlight the need to address earlier phases of the illness trajectory and integrate gender-sensitive approaches into public health efforts to promote equity in palliative care.}},
  author       = {{Zere Goitom, Johanna}},
  language     = {{eng}},
  note         = {{Student Paper}},
  title        = {{Examining gender differences in specialized palliative care: A retrospective cohort study of patients with cancer in Skåne, Sweden}},
  year         = {{2025}},
}