Most Ontarians would prefer to die at home. Why isn't that happening?
70% die in hospitals or long-term care facilities because palliative options often lacking, study finds
A new study headed by Ottawa doctor Peter Tanuseputro suggests improving end-of-life care such as house calls and other at-home palliative support could reduce the chance of patients dying in hospital by about half.
According to the study published Thursday by the Institute for Clinical Evaluation Sciences, the majority of Ontario residents would prefer to die at home, but most — nearly 70 per cent — die in hospitals or long-term care facilities.
The study looked at 264,755 deaths in Ontario from April 2010 to March 2013, and relied on secure patient health records housed at the institute.
According to a news release, the study is the largest of its kind to show the link between home visits by doctors, and where people die.
Call for provincial strategy
"Most people would be able to die at home if they had the supports in place to make that happen," said Tanuseputro, the study's lead author and a palliative care physician at the Ottawa Hospital.
"Unfortunately in most areas across Canada, it's quite arbitrary who gets palliative care in the home, depending on factors like if your family doctor does home visits, what neighborhood you live in and what you're dying of."
Tanuseputro noted that past research has suggested patients with certain diagnoses such as cancer and those who live in wealthier neighbourhoods have a higher chance of receiving home visits.
The study also found that fewer than one in five Ontario residents receives doctor house calls or palliative home care in the last year of life.
Additionally, only about 39 per cent of physicians in the province deliver palliative care, and only a small minority of those provide home visits.
"Our research points to the need for a structured palliative care strategy across the province to ensure people have a choice of dying in their homes, and not in hospitals, if they wish," Tanuseputro said.