Palliative care in Canada II: The economic perspective in rural areas

The purpose of this study is to provide policy makers, policy analysts and other groups with information regarding the economic burden of personally borne costs attributable to the palliation phase of care and the context in which they occur in three selected rural regions across Canada. This study comprises eight specific objectives: Identify and measure relevant resource utilisation during the palliative phase of care; estimate their costs; identify who delivers these goods and services; determine who pays for what; identify all relevant sources of family income; relate incomes and costs; compare the economic burden of personally borne costs in rural areas with that observed in an ongoing similar study carried out in five Canadian urban regions; determine the extent to which intra-provincial policy variation influences personal costs in rural regions across the country.Study Design: The study population is composed of terminally ill Canadian patients and of their family caregivers. This research is mainly a prospective survey of 150 family caregivers looking after terminally ill patients registered in a regional palliative care program in three rural regions in Canada (Quebec, Manitoba, Nova Scotia). Families recruited for this survey will provide information about their use of health care resources, their personal costs and any ensuing loss of income. Relevance: It is of utmost importance that policymakers gain a better understanding of the direct and indirect costs associated with palliative care in rural areas, as well as of the principal determinant of these costs. Such knowledge appears indispensable given the growing needs of an aging population which will prompt regions throughout Canada to implement integrated palliative care programs, given the growing recognition of the difficulties faced by families looking after the terminally ill at home.