Environmental scan to describe the current care received by seriously ill, frail elderly patients nearing end of life in Canada

This environmental scan describes the current care received by older Canadians living with frailty. It covers four themes: (1) healthcare services and models of care, (2) healthcare outcomes and interventions to improve them, (3) healthcare outcomes across patient cohorts, and (4) healthcare resource utilization. These themes were covered in three activities: a scoping literature review, analyses of administrative data and interviews with key stakeholders.

About the Project

In the review, we searched academic and grey literature and included reports of any type and scientific studies of any design published between 2009 and 2015. We included reports with a main focus on older Canadians living with frailty (65+). The findings were synthesized and articulated through the four themes.

In the administrative data analyses, we initially listed the quality of care measures already available in databases in Nova Scotia, prioritized these indicators through a Delphi survey of the research team members, and extracted the prioritized indicators from linked administrative databases in five provinces (Nova Scotia, Quebec, Ontario, Alberta, and British Columbia). We then conducted logistical regressions to determine the association between these indicators and four covariates, namely sex, age, community size and income.

Lastly, we interviewed a purposeful sample of 42 patients, caregivers, healthcare providers, or decision makers from the five provinces (Nova Scotia, Quebec, Ontario, Alberta, and British Columbia). Purposes of the interviews were (1) to explore their perceptions of the quality of care of older adults living with frailty and health care resource use, and (2) to prioritize quality of care indicators for older adults living with frailty.

Project Team:

Project leader:

Anik Giguère, PhD, Université Laval

Project co-leaders:

Robin Urquhart, Dalhousie University

Sharon Straus, St. Michael’s Hospital

Study coordinator:

M.B. Boulianne