K. Karim et al., Nonwhite ethnicity and the provision of specialist palliative care services: factors affecting doctors' referral patterns, PALLIAT MED, 14(6), 2000, pp. 471-478
The aim of this paper was to examine the use of palliative care services by
members of black/minority ethnic communities. Referral patterns of hospita
l consultants and general practitioners (GPs) to Birmingham St Mary's Hospi
ce were examined. Semistructured interviews were carried out to explore doc
tors' perceptions of the benefits and limitations of hospice services for t
heir black/minority ethnic patients and to identify potential barriers to r
eferral. in total, 27 doctors were interviewed: 15 hospital consultants and
12 GP. The GPs were selected according to size of practice within areas of
Birmingham with significant black/minority ethnic populations. Referrals r
eceived by the hospice for the period April 1996 to November 1997 were coll
ected from the Hospice's computerized database. Results show that, compared
to white Europeans, there was an underutilization of day care and inpatien
t hospice services by members of black/minority ethnic communities. Doctors
did, however, refer their black/minority ethnic patients for hospice home-
care services: 8.5% of referrals received by the hospice were for nonwhite
patients. This referral rate increased to 19.3% in specific postcode areas
known to have significant black/minority ethnic communities. Further resear
ch is needed to establish levels of awareness, explore attitudes towards pa
lliative care services and assess the demand for specific services within v
arious black/minority ethnic communities.