Evidence map›Paper›PMID 38926319›Full record

ArticleJournal of general internal medicine2024

A Comparison of Palliative Care Delivery between Ethnically Chinese and Non-Chinese Canadians in the Last Year of Life.

Zhimeng Jia, Allison Kurahashi, Rashmi K Sharma, Ramona Mahtani, Brandon M Zagorski, Justin J Sanders, Christopher Yarnell, Michael Detsky, Charlotta Lindvall, Joan M Teno and 2 more

Abstract readComparative Study
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Zhimeng JiaTemmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada. Zhimeng.jia@utoronto.ca.ORCID 0000-0001-8156-5553
Allison KurahashiTemmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada.
Rashmi K SharmaCambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA.
Ramona MahtaniTemmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada.
Brandon M ZagorskiICES, Toronto, Ontario, Canada.
Justin J SandersDepartment of Family Medicine, McGill University, Montreal, QC, Canada.
Christopher YarnellInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Michael DetskyInterdepartmental Division of Critical Care Medicine, University Health Network and Sinai Health System, Toronto, Ontario, Canada.
Charlotta LindvallHarvard Medical School, Boston, MA, USA.
Joan M TenoDepartment of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, RI, USA.
Chaim M BellICES, Toronto, Ontario, Canada.
Kieran L QuinnTemmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEthnically Chinese adults in Canada and the United States face multiple barriers in accessing equitable, culturally respectful care at the end-of-life. Palliative care (PC) is committed to supporting patients and families in achieving goal-concordant, high-quality serious illness care. Yet, current PC delivery may be culturally misaligned. Therefore, understanding ethnically Chinese patients' use of palliative care may uncover modifiable factors to sustained inequities at the end-of-life.

objectiveTo compare the use and delivery of PC in the last year of life between ethnically Chinese and non-Chinese adults.

designPopulation-based cohort study.

participantsAll Ontario adults who died between January 1st, 2012, and October 31st, 2022, in Ontario, Canada. EXPOSURES: Chinese ethnicity. MAIN MEASURES: Elements of physician-delivered PC, including model of care (generalist; specialist; mixed), timing and location of initiation, and type of palliative care physician at initial consultation. KEY

resultsThe final study cohort included 527,700 non-Chinese (50.8% female, 77.9 ± 13.0 mean age, 13.0% rural residence) and 13,587 ethnically Chinese (50.8% female, 79.2 ± 13.6 mean age, 0.6% rural residence) adults. Chinese ethnicity was associated with higher likelihoods of using specialist (adjusted odds ratio [aOR] 1.53, 95%CI 1.46-1.60) and mixed (aOR 1.32, 95%CI 1.26-1.38) over generalist models of PC, compared to non-Chinese patients. Chinese ethnicity was also associated with a higher likelihood of PC initiation in the last 30 days of life (aOR 1.07, 95%CI 1.03-1.11), in the hospital setting (aOR 1.24, 95%CI 1.18-1.30), and by specialist PC physicians (aOR 1.33, 95%CI 1.28-1.38).

conclusionsChinese ethnicity was associated with a higher likelihood of mixed and specialist models of PC delivery in the last year of life compared to adults who were non-Chinese. These observed differences may be due to later initiation of PC in hospital settings, and potential differences in unmeasured needs that suggest opportunities to initiate early, community-based PC to support ethnically Chinese patients with serious illness.

Indexed as

Palliative CareTerminal CareAdultAgedAged, 80 and overCohort StudiesEast Asian PeopleFemaleHumansMaleMiddle AgedNorth American PeopleOntarioend-of-lifehealth disparitiespalliative care

Identifiers

PMID38926319
PMCPMC11535090

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.