Grant: Travel Awards - Institute Community Support

It is estimated that between 16% and 30% of Canadians who die annually have access to or receive end-of-life care services, many of whom are referred to hospice programs in their last days of life. This study aims to describe and compare the characteristics of residents who received hospice care versus those who did not receive hospice care in their last year of life in long-term care facilities (LTCFs) in Canada. This retrospective cohort study used linked health administrative data from the Canadian Continuing Reporting System (CCRS) and the Discharge Abstract Database. Data in CCRS is routinely collected via the interRAI MDS 2.0. All persons residing in LTCFs between Jan. 1st, 2015 and Dec 31st, 2015 were included in this study. Death records were linked up to Dec 31th, 2016. Descriptive and inferential statistics were used to describe and compare the characteristic of residents who received hospice care versus those who did not receive hospice care in their last year of life. Among the 185,715 residents resided in LTCFs in Canada in 2015, 30.9% died within one year of assessment, and 7.7% of them received hospice care in their last days of life. Residents more likely to receive hospice care in their last year of life were: younger; male; had a do not resuscitate order; lived in urban LTCFs; had diagnosis of cancer, anemia, or gastrointestinal disease; had a diagnosis of dementia, depression, stroke, or congestive heart failure; had less severe aggressive behaviors, lower level of social engagement, more severe physical impairment, more severe pain, higher pressure ulcer risk, and exhibited severe health instability. Expanding awareness of characteristics of residents who may benefit from hospice care compared to those who actually received hospice care may help LTCFs administrators, hospice care providers, and policy makers to identify ways to implement services and interventions that can improve access, utilization, and quality of hospice care in LTCFs.