Administrative health care data can be used to examine quality indicators, including quality of end-of-life care for individuals with cancer. A recent research study by Khan et al (2021)1, sought to determine whether there were positive changes in palliative end of life care, as measured by validated quality indicators, for people dying of cancer in three Canadian provinces over a 12-year period.
The study included 376,108 patients who died from cancer between April 1, 2004 and March 31, 2015 in British Columbia, Ontario, and Nova Scotia. Quality indicators, including death in acute care hospital, new hospitalization or emergency department visit within 30 days of death, home visit within 6 months of death, physician house call within 2 weeks of death were calculated and analyzed for yearly trends.
Close to half of all patients are dying in acute care hospitals, with Ontario experiencing the greatest decline between 2004 (52.8%) and 2015 (41.1%) of the three provinces. Further, Ontario experienced the greatest decline in hospitalization rates within 30 days of death between 2004 (59.7%) and 2015 (53.2%). Ontario saw an increase in supportive care usage (defined as a physician house call in the last 2 weeks before death, or a palliative nursing or personal support visit at home in the last 6 months before death) from 44.0% in 2005 to 57.6% in 2015. This suggest that while there is still much room for improvement, end of life care for patients with cancer is increasingly aligned with important patient-defined outcomes.
The analysis also revealed little change in other quality indicators over time, such as emergency room visits within 2 weeks of death and use of aggressive care measures, suggesting that additional improvements in these areas are required.
The authors underscored the importance of connecting Canadians to palliative services, as these services are known to improve a wide variety of outcomes that are important to patients.
- Khan, A. F., Seow, H., Sutradhar, R., Peacock, S., Chan, K. K. W., Burge, F., … & Barbera, L. (2021). Quality of End-of-Life Cancer Care in Canada: A 12-Year Retrospective Analysis of Three Provinces’ Administrative Health Care Data Evaluating Changes over Time. Current Oncology, 28(6), 4673-4685. Available from: https://www.mdpi.com/1718-7729/28/6/394/htm
