title: Inequalities in end-of-life care for colorectal cancer patients in Nova Scotia, Canada.
abstract: Access to high-quality end-of-life (EOL) care is critical for all those with incurable cancer. The objective of this study was to examine inequalities in access to, and quality of, EOL care by assessing registration in a palliative care program, emergency room visits in the last 30 days of life, and location of death among individuals who died of colorectal cancer in Nova Scotia, Canada, between 2001 and 2008. We used population-based linked administrative data and performed multivariate logistic regression models to assess the association between socio-economic, geographic, and demographic factors and outcomes related to access to, and quality of, EOL care (n=1201). This study demonstrates that although access to, and quality of, EOL care appears to have improved, there remain significant inequalities throughout the population. Of primary concern is the variation in access to, and quality of, EOL care based on geographic location of residence and patient age.
authors.affiliation: Faculty of Medicine, Dalhousie University, 5849 University Avenue, Mailbox No. 257, Halifax, Nova Scotia, Canada. andre.maddison@dal.ca
authors.forename: André R
authors.initials: AR
authors.lastname: Maddison
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Asada
authors.forename: Fred
authors.initials: F
authors.lastname: Burge
authors.forename: Grace W
authors.initials: GW
authors.lastname: Johnston
authors.forename: Robin
authors.initials: R
authors.lastname: Urquhart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D010166:Palliative Care; D011787:Quality of Health Care; D012042:Registries; D012959:Socioeconomic Factors; D013727:Terminal Care