ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2024
Estimated mortality risk and use of palliative care services among home care clients during the last 6 months of life: a retrospective cohort study.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 3 citations in OpenAlex.
- Health Outcomes of Older Adults in Long-Term Care Homes Following Hospitalization for Hip Fracture Surgery: A Retrospective Observational Cohort Study in Ontario, Canada.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- Eight Ways General Internists Can Practice High-Value, Low-Carbon Care: The Canadian Society of Internal Medicine's Climate Conscious Choosing Wisely Canada Recommendations.Journal of general internal medicine · 2025Article
- Palliative care consultation teams in long-term care: a descriptive retrospective cohort study.BMC palliative care · 2025Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Canada, only 15% of patients requiring palliative care receive such services in the year before death. We describe health care utilization patterns among home care users in their last 6 months of life to inform care planning for older people with varying mortality risks and evolving care needs as they decline.
methodsUsing population health administrative data from Ontario, we performed a retrospective cohort study involving home care clients aged 50 years and older who received at least 1 interRAI (Resident Assessment Instrument) Home Care assessment between April 2018 and September 2019. We report the proportion of clients who used acute care, long-term care, and palliative home care services within 6 months of their assessment, stratified by their predicted 6-month mortality risk using a prognostic tool called the Risk Evaluation for Support: Predictions for Elder-life in their Communities Tool (RESPECT) and vital status.
resultsThe cohort included 247 377 adults, 11.9% of whom died within 6 months of an assessment. Among decedents, 50.6% of those with a RESPECT-estimated median survival of fewer than 3 months received at least 1 nonphysician palliative home care visit before death. This proportion declined to 38.7% and 29.5% among decedents with an estimated median survival between 3 and 6 months and between 6 and 12 months, respectively.
interpretationMany older adults in Ontario do not receive any palliative home care before death. Prognostic tools such as RESPECT may improve recognition of reduced life expectancies and palliative care needs of individuals in their final years of life.
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