Grant: Project Grant

Dying is something that will happen to everyone and good quality of care at the end of life is a basic human right. As people get older, and with more seniors living with some illnesses for a long time (like heart disease), we will need more health care for people who are dying, or palliative care (PC) services. There has been more money spent on PC services recently, but we really don't know much about the quality of care that people get. Much of the research in PC looks at how many people went to the hospital or where they died, but doesn't look at issues like pain, shortness of breath and depression that we know are important to the person and their family. Across Canada we have data from 5 provinces and the Yukon Territory (roughly 2.8 million records) that can help us examine the quality of PC services. These electronic data come from a survey that is completed when people are receiving home. This survey was created by interRAI, a group of researchers and clinicians from over 30 different countries. This survey includes important questions about a person's pain, depression, whether they are having trouble breathing and whether they can take care of their basic needs (e.g., getting dressed, and if they have someone to help them). From the survey questions we will define a set of quality indicators that look at things like pain, trouble breathing, depression, caregiver distress and falls. These indicators will be reported as a percent (e.g., percent of people with pain) so we can compare different health care providers from across Canada on these measures. By looking at these indicators, palliative care providers can see how they are doing and how they compare to other places. In this way, they can figure out where they might need to make some changes in order to improve the quality of care that they provide.