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From: Joan Agwuna <[log in to unmask]> Subject: KHE Seminar on Monday 2nd October 2023 - "Using Mediation Analysis to Investigate Why Socioeconomic Inequality Exists in End of Life Care" Dear all, Our next virtual King's Health Economics (KHE) Seminar "Using Mediation Analysis to Investigate Why Socioeconomic Inequality Exists in End of Life Care" will be held from 1-2 pm on Monday 2nd October. This seminar will be led by Joanna Davies, based at the Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation at King's. A summary of her talk and her bio can be found at the end of this e-mail. This is a free event, which will be taking place online via Microsoft Teams. If you are interested in attending, please book a free ticket here<https://www.eventbrite.co.uk/e/mediation-analysis-why-socioeconomic-inequality-exists-in-end-of-life-care-tickets-722857083997?utm-campaign=social&utm-content=attendeeshare&utm-medium=discovery&utm-term=listing&utm-source=cp&aff=ebdsshcopyurl>. Eventbrite event page<https://www.eventbrite.co.uk/e/mediation-analysis-why-socioeconomic-inequality-exists-in-end-of-life-care-tickets-722857083997?utm-campaign=social&utm-content=attendeeshare&utm-medium=discovery&utm-term=listing&utm-source=cp&aff=ebdsshcopyurl> Mediation Analysis: Why Socioeconomic Inequality Exists In End Of Life Care<https://www.eventbrite.co.uk/e/mediation-analysis-why-socioeconomic-inequality-exists-in-end-of-life-care-tickets-722857083997?utm-campaign=social&utm-content=attendeeshare&utm-medium=discovery&utm-term=listing&utm-source=cp&aff=ebdsshcopyurl> King's Health Economics Seminar - "Using Mediation Analysis to Investigate Why Socioeconomic Inequality Exists In End Of Life Care" www.eventbrite.co.uk<http://www.eventbrite.co.uk/> Summary of the talk Using Mediation Analysis to Investigate Why Socioeconomic Inequality Exists in End of Life Care Joanna will present on using mediation analysis to investigate reasons for social inequality in palliative and end of life care. Here is a link to her paper<https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30292-9/fulltext#:~:text=People%20with%20lower%20wealth%20were,of%20wealth%20on%20hospital%20admissions> About Joanna Davies Joanna is a post-doctoral researcher based at the Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation at King's. A summary of Joanna's research paper Background Many patients prefer to avoid hospital-based care towards the end of life, yet hospitalisation is common and more likely for people with low socioeconomic position. The reasons underlying this socioeconomic inequality are not well understood. This study investigated health, service access, and social support as potential mediating pathways between socioeconomic position and receipt of hospital-based care towards the end of life. Methods For this observational cohort study, we included deceased participants from the nationally representative English Longitudinal Study of Ageing of people aged 50 years or older in England. We used a multiple mediation model with age-adjusted and gender-adjusted probit regression to estimate the direct effect of socioeconomic position (measured by wealth and education) on death in hospital and three or more hospital admissions in the last 2 years of life, and the indirect effects of socioeconomic position via three mediators: health and function, access to health-care services, and social support. Findings 737 participants were included (314 [42·6%] female, 423 [57·4%] male), with a median age at death of 78 years (IQR 71–85). For death in hospital, higher wealth had a direct negative effect (probit coefficient −0·16, 95% CI −0·25 to −0·06), which was not mediated by any of the pathways tested. For frequent hospital admissions, health and function mediated the effect of wealth (−0·04, −0·08 to −0·01), accounting for 34·6% of the total negative effect of higher wealth (−0·13, −0·23 to −0·02). Higher wealth was associated with better health and function (0·25, 0·18 to 0·33). Education was associated with the outcomes only indirectly via wealth. Interpretation Our findings suggest that worse health and function could partly explain why people with lower wealth have more hospital admissions, highlighting the importance of socioeconomically driven health differences in explaining patterns of hospital use towards the end of life. The findings should raise awareness about the related risk factors of low wealth and worse health for patients approaching the end of life, and strengthen calls for resource allocation to be made on the basis of health need and socioeconomic profile. Kind regards, Joan Agwuna and Kang Wang Research Associate in Health Economics King's Health Economics Institute of Psychiatry, Psychology & Neuroscience King's College London Contact details of the KHE workshop and seminar organisers Joan Agwuna: [log in to unmask]<mailto:[log in to unmask]> Kang Wang: [log in to unmask]<mailto:[log in to unmask]> ######################################################################## To unsubscribe from the HEALTHECON-ALL list, click the following link: https://www.jiscmail.ac.uk/cgi-bin/WA-JISC.exe?SUBED1=HEALTHECON-ALL&A=1 This message was issued to members of www.jiscmail.ac.uk/HEALTHECON-ALL, a mailing list hosted by www.jiscmail.ac.uk, terms & conditions are available at https://www.jiscmail.ac.uk/policyandsecurity/