End of life care differ between the United States to the Canada, study finds

 the end of life for older people with advanced lung cancer care differ from the United States and in the Canadian province of Ontario, according to a new study.

U.S. patients receive much more chemotherapy, while patients in Ontario use much more of hospital services and the emergency room, according to the analysis of data from the U.S. Government and the Ontario Cancer Registry. Information was collected for persons 65 and over who dies in non-small cell lung cancer between 1999 and 2003.

Health care services have been widely used by patients in the two countries, particularly in the last month of life. More than two times more people in Ontario died in a hospital (48.5% vs 20.4%), even though most of the patients in Ontario have said they want to die at home, the study said.

The United States and the Canada seniors receive government-funded health care, but there are differences in the coverage of end of life. In the United States, palliative care for qualified patients covered by Medicare. Ontario is no palliative care program comparable to what is available in the United States, but the province offers palliative care hospital units, ambulatory services and care at home.

According to the researchers, the lack of the Canada palliative care services contributes to higher rates of Ontario visits hospital and the room of death in the hospital and emergency.

The findings, published online may 18 in the Journal of the National Cancer Institute, could help to show decision makers and planners of health where changes in practices or programs could improve care for the dyingthe researchers said.

End of life care also vary from one region to the United States and Canada, Dr. David Goodman, the Dartmouth Institute for health and clinical practice policy, wrote in an accompanying editorial newspaper.

In addition, patient preferences vary from one person to another, and these preferences are often unknown, he said. The best type of end-of life care, said Goodman, involves the patient in decision making.