Access to Palliative Care for Cancer Patients Living in a Northern and Rural Environment in Ontario, Canada: The Effects of Geographic Region and Rurality on End-of-Life Care in a Population-Based Decedent Cancer Cohort

Clinical Medicine Insights. Oncology
Michael Sc ConlonMark Hartman

Abstract

Access to palliative care has been associated with improving quality of life and reducing the use of potentially aggressive end-of-life care. However, many challenges and barriers exist in providing palliative care to residents in northern and rural settings in Ontario, Canada. The purpose of this study was to examine access to palliative care and associations with the use of end-of-life care in a decedent cohort of northern and southern, rural and urban, residents. Using linked administrative databases, residents were classified into geographic and rural categories. Regression methods were used to define use and associations of palliative and end-of-life care and death in acute care hospital. A decedent cancer cohort of Ontario residents (2007-2012). Northern rural residents were less likely to receive palliative care (adjusted odds ratio [OR] = 0.90, 95% confidence interval [CI]: 0.83-0.97). Those not receiving palliative care were more likely to receive potentially aggressive end-of-life care and die in an acute care hospital (adjusted OR = 1.20, 95% CI: 1.02-1.41). Palliative care was significantly associated with reduced use of aggressive end-of-life care; however, disparities exist in rural locations, especially those in ...Continue Reading

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Citations

Jul 15, 2020·International Journal of Environmental Research and Public Health·Jessica CerniHassan Hosseinzadeh
Dec 22, 2020·Journal of Pain and Symptom Management·Miguel Antonio Sánchez-CárdenasCarlos Centeno
Nov 17, 2020·Journal of Palliative Medicine·Mohamed AbdelaalJenny Lau
Feb 20, 2021·BMC Palliative Care·Elizabeth RostedMette Raunkiær
Mar 10, 2021·The Oncologist·Jeannette VogtUNKNOWN Arbeitsgemeinschaft Palliativmedizin (APM) of the German Cancer Society (DKG)
Aug 25, 2021·The American Journal of Hospice & Palliative Care·Maria Elena Iriarte MonchoTeresa Soria-Comes

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