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Current Oncology
Volume 22
Issue 5
10.3747/co.22.2636
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Quality of End-of-Life Cancer Care in Canada: A Retrospective Four-Province Study Using Administrative Health Care Data

by
L. Barbera
1,2,3,*,
H. Seow
3,4,
R. Sutradhar
3,
A. Chu
3,
F. Burge
5,
K. Fassbender
6,
K. McGrail
7,
B. Lawson
5,
Y. Liu
3,
R. Pataky
8 and
A. Potapov
6
1
Odette Cancer Centre, Department of Radiation Oncology, Toronto, ON, Canada
2
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
3
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
4
Department of Oncology, McMaster University, Hamilton, ON, Canada
5
Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
6
Department of Oncology, Division of Palliative Care Medicine, University of Alberta, Edmonton, AB, Canada
7
Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
8
Canadian Centre for Applied Research in Cancer Control, BC Cancer Research Centre, Vancouver, BC, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2015, 22(5), 341-355; https://doi.org/10.3747/co.22.2636
Submission received: 8 July 2015 / Revised: 4 August 2015 / Accepted: 11 September 2015 / Published: 1 October 2015

Abstract

Background: The quality of data comparing care at the end of life (eol) in cancer patients across Canada is poor. This project used identical cohorts and definitions to evaluate quality indicators for eol care in British Columbia, Alberta, Ontario, and Nova Scotia. Methods: This retrospective cohort study of cancer decedents during fiscal years 2004–2009 used administrative health care data to examine health service quality indicators commonly used and previously identified as important to quality eol care: emergency department use, hospitalizations, intensive care unit admissions, chemotherapy, physician house calls, and home care visits near the eol, as well as death in hospital. Crude and standardized rates were calculated. In each province, two separate multivariable logistic regression models examined factors associated with receiving aggressive or supportive care. Results: Overall, among the identified 200,285 cancer patients who died of their disease, 54% died in a hospital, with British Columbia having the lowest standardized rate of such deaths (50.2%). Emergency department use at eol ranged from 30.7% in Nova Scotia to 47.9% in Ontario. Of all patients, 8.7% received aggressive care (similar across all provinces), and 46.3% received supportive care (range: 41.2% in Nova Scotia to 61.8% in British Columbia). Lower neighbourhood income was consistently associated with a decreased likelihood of supportive care receipt. Interpretation: We successfully used administrative health care data from four Canadian provinces to create identical cohorts with commonly defined indicators. This work is an important step toward maturing the field of eol care in Canada. Future work in this arena would be facilitated by national-level data-sharing arrangements.
Keywords: Palliative care; quality indicators; health services research Palliative care; quality indicators; health services research

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MDPI and ACS Style

Barbera, L.; Seow, H.; Sutradhar, R.; Chu, A.; Burge, F.; Fassbender, K.; McGrail, K.; Lawson, B.; Liu, Y.; Pataky, R.; et al. Quality of End-of-Life Cancer Care in Canada: A Retrospective Four-Province Study Using Administrative Health Care Data. Curr. Oncol. 2015, 22, 341-355. https://doi.org/10.3747/co.22.2636

AMA Style

Barbera L, Seow H, Sutradhar R, Chu A, Burge F, Fassbender K, McGrail K, Lawson B, Liu Y, Pataky R, et al. Quality of End-of-Life Cancer Care in Canada: A Retrospective Four-Province Study Using Administrative Health Care Data. Current Oncology. 2015; 22(5):341-355. https://doi.org/10.3747/co.22.2636

Chicago/Turabian Style

Barbera, L., H. Seow, R. Sutradhar, A. Chu, F. Burge, K. Fassbender, K. McGrail, B. Lawson, Y. Liu, R. Pataky, and et al. 2015. "Quality of End-of-Life Cancer Care in Canada: A Retrospective Four-Province Study Using Administrative Health Care Data" Current Oncology 22, no. 5: 341-355. https://doi.org/10.3747/co.22.2636

APA Style

Barbera, L., Seow, H., Sutradhar, R., Chu, A., Burge, F., Fassbender, K., McGrail, K., Lawson, B., Liu, Y., Pataky, R., & Potapov, A. (2015). Quality of End-of-Life Cancer Care in Canada: A Retrospective Four-Province Study Using Administrative Health Care Data. Current Oncology, 22(5), 341-355. https://doi.org/10.3747/co.22.2636

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