People who Receive Palliative Care Services in the Community
We track the percentage of people who lived in the community during their last 90 days of life and had a physician visit or palliative care service in their home. Understanding the proportion of people receiving home care at the end-of-life and dying at home is useful for measuring palliative care quality in the health system.
Figure 1: Percentage of people who died in the community in Ontario and who received physician home visit(s) and/or palliative home care in the last 90 days of life, by fiscal year
Table 1: Percentage of people who died in the community in Ontario and who received physician home visit(s) and/or palliative home care in the last 90 days of life, by fiscal year
| Fiscal Year | Target % | Ontario % | Denominator Number of non-institutionalized people who died in the community in Ontario, in a fiscal year. |
Numerator The number of non-institutionalized people who died in the community in Ontario who received at least one palliative home care service or any physician home visit within their last 90 days of life. |
|---|---|---|---|---|
| 2011-2012 | N/A | 30.95% | 67,260 | 20,816 |
| 2012-2013 | N/A | 31.71% | 69,805 | 22,135 |
| 2013-2014 | N/A | 33.47% | 69,750 | 23,344 |
| 2014-2015 | N/A | 34.54% | 72,102 | 24,901 |
| 2015-2016 | N/A | 35.38% | 74,062 | 26,204 |
| 2016-2017 | N/A | 35.91% | 77,471 | 27,820 |
| 2017-2018 | N/A | 35.64% | 80,712 | 28,762 |
| 2018-2019 | 39.06% | 35.71% | 81,472 | 29,094 |
| 2019-2020 | 41.25% | N/A | N/A | N/A |
Indicator description: This indicator measures the proportion of people who received palliative care at home at the end of life.
Target for fiscal year 2018/19: 39.06%
Goal: 39.06% of non-institutionalized people who die in community should receive at least one palliative home care service or any physician home visit within their last 90 days of life by the end of March 2019.
Figure description: The line graph shows the target and actual proportion of people who died in the community and who received physician home visit(s) and/or palliative home care in their last 90 days of life. It represents data in Ontario over time, from fiscal year 2011/12 to fiscal year 2018/19.
Overall, the proportion increased gradually between 2011/12 and 2018/19, from 30.95% to 35.71%, short of the provincial target of 39%. The target rises to 41.25% in 2019/20. See data table for details.
Emergency Department Visits at End-of-Life
Emergency department visits may be appropriate or unavoidable to take care of some palliative care needs. Unplanned emergency department visits at end-of-life can indicate a lack of needed palliative care supports in the community. Such visits may lead to aggressive treatments or avoidable admissions to hospital, which may not align with the patients’ goals of care or wishes. They also may result in higher health care costs for the system.
Figure 2: Percentage of people who died in Ontario who visited the emergency department in their last 30 days of life, by fiscal year
Table 2: Percentage of people who died in Ontario who visited the emergency department in their last 30 days of life, by fiscal year
| Fiscal Year | Target % | Ontario % | Denominator Number of people in Ontario who died in reporting period who were not in an acute care hospital in the last 30 days of life. |
Numerator The number of people in Ontario who died in reporting period who had one or more unplanned emergency department visits in their last 30 days of life. |
|---|---|---|---|---|
| 2011-2012 | N/A | 55.99% | 82,080 | 45,958 |
| 2012-2013 | N/A | 55.44% | 85,493 | 47,400 |
| 2013-2014 | N/A | 55.77% | 85,439 | 47,651 |
| 2014-2015 | N/A | 56.12% | 89,030 | 49,960 |
| 2015-2016 | N/A | 54.90% | 90,036 | 49,431 |
| 2016-2017 | N/A | 54.22% | 94,793 | 51,398 |
| 2017-2018 | N/A | 54.06% | 98,234 | 53,107 |
| 2018-2019 | 52.38% | 54.12% | 97,951 | 53,009 |
| 2019-2020 | 50.17% | N/A | N/A | N/A |
Indicator description: This indicator measures the percentage of people who died in Ontario who had one or more unplanned emergency department visits in their last 30 days of life.
Target for Fiscal Year 2018/19: 52.38%
Goal: Not more than 52.38% of people who died in Ontario should have one or more emergency department visits in their last 30 days of life by the end of March 2019.
Figure Description: The line graph shows the target and actual proportion of people who died in Ontario who had one or more emergency department visit in their last 30 days of life. It represent data in Ontario over time, from fiscal year 2011/12 to fiscal year 2018/19.
Overall, the proportion decreased slightly between 2011/12 and 2018/19, from approximately 56% to 54.12%, short of the provincial target of 52.38%. The target falls to 50.17% in 2019/20. See data table for details.
Location of Death
Most people prefer to die at home if the care and support they need is available. Measuring the percentage of people who died in hospital and other locations helps us understand how well we have met that expectation in a given year.
Figure 3: Percentage of people in Ontario who died in hospital, by fiscal year
Table 3: Percentage of people in Ontario who died in hospital, by fiscal year
| Fiscal Year | Target % | Ontario % | Denominator Number of people in Ontario who died in the reporting period. |
Numerator The number of people who died in hospital during the reporting period. |
|---|---|---|---|---|
| 2011-2012 | N/A | 56.80% | 87,335 | 49,608 |
| 2012-2013 | N/A | 55.83% | 90,798 | 50,688 |
| 2013-2014 | N/A | 55.64% | 90,381 | 50,291 |
| 2014-2015 | N/A | 55.39% | 93,977 | 52,050 |
| 2015-2016 | N/A | 53.52% | 94,809 | 50,740 |
| 2016-2017 | N/A | 51.98% | 99,687 | 51,814 |
| 2017-2018 | N/A | 52.04% | 103,407 | 53,815 |
| 2018-2019 | 50.91% | 51.73% | 103,525 | 53,554 |
| 2019-2020 | 48.56% | N/A | N/A | N/A |
Indicator description: This indicator measures the proportion of people who died in hospital (inpatient, emergency department, complex continuing care, rehabilitation).
Target for Fiscal Year 2018/19: 50.91%
Goal: Not more than 50.91% of people should die in hospital by the end of March 2019.
The line graph shows the target and actual proportion of people who died in hospital. It represents data in Ontario over time, from fiscal year 2011/12 to fiscal year 2018/19.
Overall, the proportion decreased gradually between 2011/12 and 2018/19 from 56.80% to 51.73%, slightly short of the provincial target of approximately 51%. The target falls to approximately 49% in 2019/20. See data table for details.
Reports about Current State and Access to Palliative Care in Ontario/Canada
Update 2019 on Palliative Care at the End of Life Report – Health Quality Ontario (now part of Ontario Health) (October 2019)
Access to Palliative Care in Canada – Canadian Institute for Health Information (September 2018)
Palliative and End-of-Life Care – Canadian Partnership Against Cancer (September 2017)
Right to Care: Palliative Care for all Canadians (at Palliative care in critical condition: report) – Canadian Cancer Society (January 2016)
Statement of Information Practices
The data used to generate these measures comes from an Ontario Health (Cancer Care Ontario) data repository that contains personal health information (PHI). Therefore we are subject to the CCO Statement of Information Practices.
Do not use these measures, either alone or with other information, to identify an individual. This includes attempting to decrypt information, or identify an individual based on encrypted information or prior knowledge.
We use this data to enable performance management and quality improvement, and report on how implementing our action plan affects hospice palliative care in the province.