Prevalence of palliative patients and their health services utilization in the Regina Qu'Appelle regional health authority

Abstract

This population-based, retrospective descriptive analysis was conducted to study a cohort of decedents who died between January 2004 and December 2005 who were referred to the Regina Qu’Appelle Palliative Care Services (RQPCS). Demographics, diagnostic information and palliative service utilization were collected and analyzed. The first step of the analysis included interviewing the program director and clinical consultant of the RQPCS. They provided the program vision and philosophy of the RQPCS as well as a comprehensive description of the program, including descriptions of the services offered and the staff of the palliative care team.The second step of the research described in detail the demographics, palliative care service use and diagnostic background of the patients of the RQPCS. The variables of interest were age, gender, marital status, living arrangements, area of residence and diagnosis. Analysis also included determining which services the decedents accessed and how many of the services were used by each decedent. Timing of referrals and location of death were also analyzed. Frequencies and percentages were used to describe categorical variables. Means, median and range were used for continuous variables. The third step of this thesis tested for associations between patient attributes and palliative care services utilization, timing of referral and location of death using chi-square analyses. This research determined each of the patient characteristics under investigation to be associated with palliative care utilization. Similar findings were also evident in the literature. In particular, age, marital status, living arrangements, area of residence and diagnosis appeared to be significantly associated with accessing palliative care services. When analyzing the associations between patient attributes and timing of referrals for the RQPCS, no significant results were found. Previous research indicated strong associations between marital status and diagnosis on the timing of referrals into hospice and palliative care programs.Finally, there were two significant associations found between location of death and patient characteristics (gender and living arrangements). However, no clear conclusion could be reached on whether age, gender, marital status, living arrangement, area of residence or diagnosis had any effect on place of death in previous literature.