Edmonton regional palliative care program: impact on patterns of terminal cancer care

THE EDMONTON REGIONAL PALLIATIVE CARE PROGRAM was established in July 1995 to measure the access of patients with terminal cancer to palliative care s ervices, decrease the number of cancer-related deaths in acute care facilit ies and increase the participation of family physicians in the care of term inally ill patients. In this retrospective study the authors compared the p attern of care and site of deaths before establishment of the program (1992 /93) and during its second year of operation (1996/97). Significantly more cancer-related deaths occurred in acute care facilities in 1992/93 than in 1996/97 (86% [1119/1304] v. 49% [633/1279]) (p less than or equal to 0.001) . The number of inpatient days decreased, from 24 566 in 1992/93 to 6960 in 1996/97. More cancer patients saw a palliative care consult team in 1996/9 7 than in 1992/93 (82% v. 22%). The shift from deaths in acute care facilit ies to palliative hospices suggests that the establishment of an integrated palliative care program has increased access of patients with terminal can cer to palliative care.