Inpatient Palliative Care Consultations From a Canadian Clinical Teaching Unit: Who is Referred and When?

Inpatient palliative care consultation has been demonstrated to improve quality of life as well as decrease hospital readmissions, intensive care unit transfers, and hospital costs for people with a life limiting illness. The clinical teaching units (CTUs) at London Health Sciences Centre (LHSC) routinely admit patients with noncurable cancer as well as end-stage heart, lung, liver, or kidney disease. However, the use of inpatient palliative care consultations for CTU patients remains unexamined.

Inequity in access to guideline-recommended colorectal cancer treatment in Nova Scotia, Canada.

Cancer continues to be one of the heaviest burdens of disease in Canada, and assessing potential inequities in access to cancer care may serve as a barometer of the health of Canadian health systems. This study tackled three limitations of the current literature by clearly differentiating between inequality and inequity, by assessing inequity in receipt of care and wait times for care, and by taking advantage of inequity indices to enhance comparability of inequities between studies and populations. We measured income-, age-, sex- and distance-related inequities among colorectal cancer (CRC) patients in Nova Scotia by accounting for clinical guidelines and patient need.

Inequalities in end-of-life care for colorectal cancer patients in Nova Scotia, Canada.

Access to high-quality end-of-life (EOL) care is critical for all those with incurable cancer. The objective of this study was to examine inequalities in access to, and quality of, EOL care by assessing registration in a palliative care program, emergency room visits in the last 30 days of life, and location of death among individuals who died of colorectal cancer in Nova Scotia, Canada, between 2001 and 2008. We used population-based linked administrative data and performed multivariate logistic regression models to assess the association between socio-economic, geographic, and demographic factors and outcomes related to access to, and quality of, EOL care (n=1201).

Preventive medication use among persons with limited life expectancy.

Persons with limited life expectancy (LLE) - less than 1 year - are significant consumers of health care, are at increased risk of polypharmacy and adverse drug events, and have dynamic health statuses. Therefore, medication use among this population must be appropriate and regularly evaluated. The objective of this review is to assess the current state of knowledge and clinical practice presented in the literature regarding preventive medication use among persons with LLE.

Will universal access to antiretroviral therapy ever be possible? The health care worker challenge.

The United Nations millennium development goal of providing universal access to antiretroviral therapy (ART) for patients living with HIV/AIDS by 2010 is unachievable. Currently, four million people are receiving ART, of an estimated 13.7 million who need it.

Inequity in access to cancer care: a review of the Canadian literature.

Despite the policy and research attention on ensuring equitable access--equal access for equal need--to health care, research continues to identify inequities in access to cancer services. We conducted a literature review to identify the current state of knowledge about inequity in access to cancer health services in Canada in terms of the continuum of care, disease sites, and dimensions of inequity (e.g.