Table 2.
End of life (EOL) health service quality indicators for all patients and by receipt of palliative intent treatment.
| All Patients N = 37,203 |
Palliative Intent Treatment N = 19,668 |
No Palliative Intent Treatment N = 17,535 |
p-Value | ||||
|---|---|---|---|---|---|---|---|
| Outcome | Frequency | Percent (%) | Frequency | Percent (%) | Frequency | Percent (%) | |
| Aggressive care * | 18,692 | 50.26 | 8962 | 45.58 | 9730 | 55.51 | <0.001 |
| Aggressive care £ | 7833 | 21.81 | 3937 | 20.59 | 3896 | 23.20 | <0.001 |
| Supportive care ** | 20,515 | 60.30 | 13,139 | 70.30 | 7376 | 48.11 | <0.001 |
| Individual indicators of aggressive care | |||||||
| >1 Emergency department visit **** | 1372 | 3.84 | 773 | 4.05 | 599 | 3.59 | 0.025 |
| >1 Hospital inpatient admission **** | 3174 | 8.88 | 1524 | 7.99 | 1650 | 9.90 | <0.001 |
| ICU admission **** | 3556 | 9.56 | 1311 | 6.67 | 2245 | 12.80 | <0.001 |
| Death in hospital | 16,756 | 45.04 | 7731 | 39.31 | 9025 | 51.47 | <0.001 |
| Palliative systemic therapy *** | 1056 | 2.84 | 1056 | 5.37 | 0 | 0.00 | <0.001 |
| Individual indicators of supportive care | |||||||
| Palliative nursing or PSW home visit ***** | 19,385 | 52.15 | 12,562 | 63.89 | 6823 | 38.97 | <0.001 |
| Physician home visit *** | 9070 | 27.82 | 5686 | 32.05 | 3384 | 22.77 | <0.001 |
| Other | |||||||
| Mental health symptoms **** | 2786 | 7.49 | 1427 | 7.26 | 1359 | 7.75 | 0.070 |
| Number of days from first access to palliative care consultation ¥ to death | |||||||
| >180 | 2703 | 7.27 | 2086 | 10.61 | 617 | 3.52 | <0.001 |
| 61–180 | 4000 | 10.75 | 2897 | 14.73 | 1103 | 6.29 | |
| 31–60 | 2930 | 7.88 | 1975 | 10.04 | 955 | 5.45 | |
| ≤30 | 6725 | 18.08 | 3481 | 17.70 | 3244 | 18.50 | |
| None | 20,845 | 56.03 | 9229 | 46.92 | 11,616 | 66.24 | |
PSW, Personal Support Worker; * Composite score for occurrence of any one or more of the aggressive care indicators; ** Composite score for occurrence of any one or more of the supportive care indicators; *** Within 2 weeks of death; **** Within 30 days of death; ***** Within 6 months of death; Notes: Denominators for end-of-life indicators differed depending on the eligibility criteria used to derive them; Denominator for physician home visits excludes patients with ≥2-week hospital stay before death; Denominators for emergency department visits and inpatient admissions exclude patients with ≥30-day hospital stay before death; Denominator for palliative nursing or PSW home visit excludes patients with ≥6-month hospital stay before death; Denominators for composite scores for aggressive and supportive care are different due to the patients excluded from their respective individual indicators. £ Composite score for occurrence of any one or more of the aggressive care indicators, except for death in hospital. ¥ OHIP billing codes: A945, C945.