Factors influencing progressive utilization of palliative care services among Cancer patients in Kenya: The case of Nairobi hospice

Abstract

Introduction: The increasing cases of non-communicable diseases specifically cancer has led to incorporation of palliative care in the management. However, only 10% of these patients have access to palliative care (WHO, 2014). Healthcare utilization is an important step to disease management as it is helps provide individuals with opportunities for prevention and treatment of diseases. The study applied the PEN-Andersen behavioural model by use of a binary probit to estimate the progressive utilization of palliative care services by cancer patients. Objectives: The aim of the study was to determine factors influencing progressive utilization of palliative care by cancer patients. Methodology: A cross-sectional data survey was conducted for 169 cancer patients seeking palliative care at the Nairobi Hospice in 2013. For each patient, the predisposing, enabling and need (PEN) factors were analysed. Nairobi County is a proxy for distance implying progressive utilization of palliative care compared to those residing in other counties in the study. Finding: Descriptive statistics showed that 27% of patients reside in Nairobi County, 61% were females, 62% were married, 35% had primary education, 44% were self-employed and 59% had medical insurance. Probit regression and marginal effects showed that age, gender, education level employment and Muslim religion were significant in determining the progressive utilization of palliative care Conclusion: Age, gender, educational level, employment status and religion are the major factors that both government and health related Non-Governmental Organization need to consider in an effort to increase the probability of progressively utilizing palliative care so as to improve the health status of cancer patients.