Grant: Project Grant

Canadians are living longer and they often experience one or more illnesses for a period of time near the end of life. This can require increases in use of health care and the need to see numerous physicians. When a person sees the same physician over time, this is "continuity of care". Studies have been done outside the end-of-life period where continuity is associated with better outcomes like reduced hospitalizations. We know it may be necessary to disrupt the continuity that exists with seeing the same healthcare professionals near the end of life, to ensure the best care for patients. Care at the end of life often involves multiple physicians. Different specialists may treat a patient's diseases, a family physician may help coordinate care and treat the patient's symptoms, and a palliative care home care team may be involved. Or the family physician may provide all care with help from a palliative care specialist. If we use the same continuity measures used in other areas of healthcare, we may miss important benefits of different patterns of care at end of life. This project will analyze Ontario's healthcare data to look at patterns of continuity during the last year of life. We will evaluate how often people experience different patterns and their outcomes. We will design and exhibit a design installation that will solicit feedback from the public on our findings. We will also ask family caregivers what type of continuity was best and worst for their loved ones at the end of life. This study will provide evidence and develop a theory of whether and how patterns of continuity of care enhance outcomes important to patients and the healthcare system at end-of-life. The team plans to raise awareness about the role that continuity of care serves in the end-of life-period by presentations to health system leaders, and a second design installation that incorporates findings from the quantitative and qualitative phases of the project.