The Evolution of Hospice Palliative Care Policy and Practice in Ontario, Canada
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The Evolution of Hospice Palliative Care Policy and Practice in Ontario, Canada. Introduction. Ontario: Demography & Geography Urban vs. Rural South vs. North Local Health Integration Networks (LHINs).

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The Evolution of Hospice Palliative Care Policy and Practice in Ontario, Canada

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The evolution of hospice palliative care policy and practice in ontario canada

The Evolution of Hospice Palliative Care Policy and Practice in Ontario, Canada


Introduction

Introduction

Ontario: Demography & Geography

Urban vs. Rural

South vs. North

Local Health Integration Networks (LHINs)

Figure 1: Ontario Local Health Integration Network Boundaries. Map available at: http://www.lhins.on.ca


Methods

Methods

Review of academic & grey literatures

Preliminary timelines

Review of timelines by key informants (n=8)

Follow-up semi-structured interviews with key informants

Thematic content analysis of interview data (Aronson, 1994) & revision of timelines by research team


Results

Chronological list of provincial hospice palliative care (HPC) key milestones from 1979 to 2009

1. Late1970s & 1980s: The Foundational Years

2. 1990s: Increased Provincial Government Involvement

3. 2000-2009: Union of Stakeholders

Influence of federal government

Role of associations and advocates

Rural lag: “Rural care is like a big black hole.”

Results


1 the foundational years

Late 1970s and 1980s

Origin of HPC in Canada

1979: 1st community-based hospice

Provincial associations established

1. The Foundational Years


2 on gov t takes notice of hpc

2. ON Gov’t Takes Notice of HPC

1990s: Few HPC milestones

Education funding provided by Ministry of Health

Health Care Services Restructuring: Shift to community care

Rural health service delivery challenges acknowledged

National senate committee report


3 stakeholders unite for hpc

3. Stakeholders Unite for HPC

2000-2009

National report: Quality End of Life Care: The Right of Every Canadian; HPC funds through 2003 Canadian Federal Health Accord

End-of-Life Care Strategy enacted in 2005; Networks established

Rural education initiatives through Pallium (2004-2006) & federal support for residential hospices

Two provincial associations host first collaborative HPC conference in 2009

HPC Provincial Think Tank in 2009 & stakeholder group forms


Conclusion

HPC in Ontario has evolved over the last 30 years and continues to move forward

Rural areas continue to lag behind but there is movement taking place

Increased efforts on integration and coordination of care

HPC Networks & unity of stakeholders holds potential

Conclusion


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