Inequalities in end-of-life care for cancer patients: Do they exist and what contributes to them?

Improving care at the end-of-life is of growing importance to Canadians. Our population is aging and we face longer lives with prolonged experiences of multiple chronic diseases. One of these is cancer, the leading cause of death among Canadians. Given that the major driving force behind the increasing demands for end-of-life care is the growing number of elderly in our population, we need to know what care is being provided and the relationship between care and end-of-life outcomes, such as location of death. We also need to know what population characteristics and health system factors are associated with this care and whether there are inequalities or differences in care provided depending on one¿s age, gender or geographic region. Therefore, the objective of this study is to (1) examine the differences in health service use and end-of-life outcomes related to age and gender, and (2) to identify population characteristics (individual and community) and health care system factors contributing to these differences. To meet these objectives, this study will use administrative health data and Statistics Canada information associated with all cancer deaths in Nova Scotians between 1998 and 2003. The results of the proposed study will provide much needed evidence for national, provincial and local health agencies developing policy and programs for dying Canadians.