Community care helping to drive small improvements in access to palliative care for Canadians

New data from the Canadian Institute for Health Information (CIHI) shows that 58% of Canadians who died in 2021–2022 received palliative care, an increase from 52% in 2016–2017. CIHI’s report Access to Palliative Care in Canada, 2023, released today, measures progress toward increasing Canadians’ access to palliative care and builds on the 2018 report on the same topic.

Palliative care can include a variety of services focused on managing symptoms, reducing pain and providing psychological, social, emotional, spiritual and practical support. This report found the following: 

• Among those who received some form of palliative care, 61% had palliative care in hospital only, while 36% received palliative home care.
• Younger seniors — age 65 to 84 at time of death — were the group most likely to receive palliative care, followed by those age 19 to 64. Canadians 85 and older who died were less likely to receive palliative care than younger people.
• Cancer patients were the most likely to be identified as palliative in the last year of life (77%), while those with dementia were the least likely (39%).

Palliative care helps people with life-limiting conditions remain at home as long as possible. Many provincial and national surveys have found that, given the choice, most Canadians would prefer to die at home. In 2021–2022, 13% of Canadians died at home with palliative care  — an increase from 7% in 2016–2017. Patients supported by palliative home care spent fewer days on average in hospital in the last year of their lives, compared with those who received palliative care only in hospital (18 days versus 28 days, respectively). 

“While it is encouraging to see some progress in Canadians’ ability to access palliative care, better data is needed to understand a more holistic picture of the barriers Canadians face,” said Tracy Johnson, Director, Health System Analytics, CIHI. “To better understand whether Canadians are receiving equitable access to palliative care, we need to identify which specific palliative services patients should receive and look at whether patients of different ages and with various types of illnesses are receiving those services across the country.”

“When people can receive palliative care, it drastically improves their quality of life. However, not everyone can access this care, especially if they have a non-cancerous illness, live in a rural area with few services or there are no beds available,” said Laurel Gillespie, CEO, Canadian Hospice Palliative Care Association. “A 1-month wait for specialized care or a hospice bed may seem short, but for someone with weeks to live and their family, it’s an agonizing wait hoping that it won’t come too late.”  

Data in the 2023 report is from Ontario, Alberta, B.C. and Yukon; data in the 2018 report is from Ontario and Alberta. These provinces and territory are used as a proxy for all of Canada.