Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Bruyère Research Institute, Ottawa, Canada.
J Am Med Dir Assoc. 2023 Dec;24(12):1849-1854.e1. doi: 10.1016/j.jamda.2023.06.007. Epub 2023 Jul 14.
Because of an increasing need to build capacity for end-of-life care, improving access to palliative care is a priority. Where a physician practices (eg, hospital, outpatient clinic, home) directly relates to the type of service and the stage of illness at which care is provided. In this study, we describe the physician palliative care specialist workforce and the settings of care within which they practice.
A retrospective cohort.
All physicians with palliative care billing codes who were practicing between April 1, 2018, and March 31, 2019, in Ontario, Canada.
Descriptive statistics of physician billing location and frequency using linked population-based health administrative data.
We identified 8883 physicians who provided palliative care during the study period. Of those, 723 (8.1%) were classified as palliative care specialists (>10% of their billings encounters were palliative care). The majority (57.4%) of palliative care specialists worked in 1 setting more than 90% of their time, across home visits (27.1%), indirect care (22.4%), and office (7.9%). There were 61 palliative care specialists practicing in mixed locations who provided home visits, meaning 310 (42.9%) of the palliative care specialists delivered some home-based care.
This research provides a comprehensive description of the current palliative care specialist physician workforce that can support efforts to build capacity for high-quality end-of-life care.
由于对临终关怀能力建设的需求不断增加，改善姑息治疗的可及性是当务之急。医生的执业地点（如医院、门诊诊所、家庭）直接关系到所提供服务的类型和疾病的阶段。在这项研究中，我们描述了姑息治疗专家医生的劳动力以及他们执业的护理环境。
回顾性队列研究。
2018 年 4 月 1 日至 2019 年 3 月 31 日期间在加拿大安大略省执业的所有具有姑息治疗计费代码的医生。
使用链接的基于人群的健康管理数据，对医生计费地点和频率进行描述性统计。
我们确定了在研究期间提供姑息治疗的 8883 名医生。其中，723 名（8.1%）被归类为姑息治疗专家（其计费就诊中超过 10%为姑息治疗）。大多数（57.4%）姑息治疗专家超过 90%的时间在 1 个环境中工作，包括家访（27.1%）、间接护理（22.4%）和办公室（7.9%）。有 61 名姑息治疗专家在混合地点执业，提供家访服务，这意味着 310 名（42.9%）姑息治疗专家提供了一些基于家庭的护理。
这项研究全面描述了当前的姑息治疗专家医生劳动力，这可以为加强高质量临终关怀能力建设的努力提供支持。
