Research Article
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Published Online: 11 May 2012

Availability of Services in Ontario Hospices and Hospitals Providing Inpatient Palliative Care

Publication: Journal of Palliative Medicine
Volume 15, Issue Number 5

Abstract

Purpose: Most Canadians die in inpatient settings. Our aim was to determine the availability of medical services, programs, and care for common palliative procedures, in hospices, palliative care units (PCUs), and hospital medical wards (MWs) providing inpatient palliative care in Ontario, Canada.
Methods: We identified facilities providing inpatient palliative care using the Ontario Hospital Association (OHA) and Hospice Association of Ontario (HAO) websites. An electronic survey was sent to the person responsible for palliative care at each facility. We compared services available among the three types of units, using Fisher's exact and Kruskal-Wallis tests.
Results: Of 128 surveys sent, 102 (80%) were completed and returned, from 58 MWs, 31 PCUs, and 13 hospices. MWs were the most common location of palliative care overall, particularly in rural areas. PCUs were most likely to provide care for common procedures (e.g., tracheostomy, nephrostomy; p<0.01); methadone for pain management (p<0.0001); and palliative radiation (p<0.01). MWs were most likely to offer intravenous chemotherapy and antibiotics (p<0.01). Transfusions were available in most PCUs and MWs, but only in one hospice (p<0.0001). Hospices were most likely to provide complementary therapies. Lack of financial support and human resources were the most frequent perceived barriers to providing quality palliative care.
Conclusions: There is considerable variability of available services depending on the setting where inpatient palliative care is provided. Further financial support and resources are required to ensure consistent high quality of care in both urban and rural areas.

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Information & Authors

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Published In

cover image Journal of Palliative Medicine
Journal of Palliative Medicine
Volume 15Issue Number 5May 2012
Pages: 527 - 534
PubMed: 22512831

History

Published online: 11 May 2012
Published in print: May 2012
Published ahead of print: 18 April 2012
Accepted: 12 December 2011

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Affiliations

Kathryn Towns, M.D.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Ontario, Canada.
Elizabeth Dougherty, M.S.W.
Department of Psychosocial Oncology and Palliative Care, University Health Network, Toronto, Ontario, Canada.
Nanor Kevork, B.Sc.
Department of Psychosocial Oncology and Palliative Care, University Health Network, Toronto, Ontario, Canada.
David Wiljer, Ph.D.
Oncology Education/Radiation Medicine Program, University Health Network, Toronto, Ontario, Canada.
Dori Seccareccia, M.D.
Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Ontario, Canada.
Department of Psychosocial Oncology and Palliative Care, University Health Network, Toronto, Ontario, Canada.
Gary Rodin, M.D.
Department of Psychiatry, University of Toronto, Ontario, Canada.
Department of Psychosocial Oncology and Palliative Care, University Health Network, Toronto, Ontario, Canada.
Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
Lisa W. Le, M.Sc.
Department of Biostatistics, University Health Network, Toronto, Ontario, Canada.
Camilla Zimmermann, M.D., Ph.D.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Ontario, Canada.
Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Ontario, Canada.
Department of Psychosocial Oncology and Palliative Care, University Health Network, Toronto, Ontario, Canada.
Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.

Notes

Address correspondence to:Camilla Zimmermann, M.D. Ph.D.Palliative Care ProgramDepartment of Psychosocial Oncology and Palliative CarePrincess Margaret Hospital610 University Avenue, 16-712Toronto, Ontario,Canada
M5G 2M9E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist for any of the authors.

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