Comparison of End-of-Life Care Between Recent Immigrants and Long-standing Residents in Ontario, Canada

Quach, Bradley I; Qureshi, Danial; Talarico, Robert; Hsu, Amy; Tanuseputro, Peter

doi:10.1001/jamanetworkopen.2021.32397

Cited by 7 publications

(10 citation statements)

References 45 publications

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“…Disparities persist at the end of life; immigrants have less education on palliative care and hospice options, and they experience delays in access to advanced care planning . Compared with nonimmigrants, immigrants are more likely to receive aggressive care at the end of life and less likely to receive supportive care, leading to higher rates of in-hospital death …”

Section: Barriers To Returning Homementioning

confidence: 99%

Medical Travel for Immigrant Patients With Cancer—Returning Home

Swami,

Dee,

Florez

2023

JAMA Oncol

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Section: Barriers To Returning Homementioning

confidence: 99%

Medical Travel for Immigrant Patients With Cancer—Returning Home

Swami,

Dee,

Florez

2023

JAMA Oncol

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“…The quantitative studies were with immigrant populations including a proportion of Black participants ranging from 0.3 to 5% of the study population (from 25 to 2606 participants). Studies with immigrant populations mainly reported information about people of African origin, without identifying Blacks from other world regions [ 28 , 29 ]. Participants in all quantitative studies except for one were cancer decedents, while for all qualitative studies and one quantitative study [ 28 ], they were family caregivers, spiritual leaders and/ or next of kin of deceased patients.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies reported patient diagnosis and this included cancer [ 13 , 32 ], and patients living with a late-stage condition [ 31 ]. Most Ontario studies used databases of patient records [ 13 , 29 , 30 ], while all Nova scotia studies were conducted in community settings. Study characteristics and key findings are presented on Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Inequities in access to palliative and end-of-life care in the black population in Canada: a scoping review

Bassah,

Beranek,

Kennedy

et al. 2024

Int J Equity Health

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Background Improving equity and early access to palliative care for underserved populations in Canada is a priority. Little is known regarding access to palliative and end-of-life care in the Black population. Methods We undertook a scoping review using the framework by Arksey and O’Malley to identify knowledge, access gaps, and experiences of palliative and end-of-life care among Blacks living with life-limiting illnesses in Canada. Primary studies, discussion papers, books, and reports were considered eligible. We followed a comprehensive search strategy developed by an information scientist. Searches were performed in the following bibliographic databases: Medline, EMBASE, PsycINFO via OVID, CINAHL via EBSCOhost, Scopus and Cochrane Library via Wiley. The search strategy was derived from three main concepts: (1) Black people; (2) Canada and Canadian provinces; (3) Palliative, hospice, or end-of-life care. No publication date or language limits were applied. Titles and abstracts were screened for eligibility by one reviewer and full text by two independent reviewers. Results The search yielded 233 articles. Nineteen articles were selected for full-text review, and 7 articles met the inclusion criteria. These studies were published between 2010 and 2021, and conducted in the provinces of Ontario and Nova Scotia only. Studies used both quantitative and qualitative methods and included cancer decedents, next of kin, family caregivers and religious leaders. Sample sizes in various studies ranged from 6 − 2,606 participants. Included studies reported a general lack of understanding about palliative and end-of-life care, positive and negative experiences, and limited access to palliative and end-of-life care for Blacks, across all care settings. Conclusion Findings suggest limited knowledge of palliative care and inequities in access to palliative and end-of-life care for Blacks living with life-limiting illnesses in 2 Canadian provinces. There is an urgent need for research to inform tailored and culturally acceptable strategies to improve understanding and access to palliative care and end-of-life care among Blacks in Canada.

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“…This complicates the ability of immigrants to establish relationships with physicians and, as highlighted by our results, receive better emergency care than in outpatient clinics or from general practitioners. In population-based cohort studies, it was found that recent immigrants were 1.2fold more likely to use emergency care services at the end of life and 1.1-fold more likely to die in acute care settings compared with longstanding residents [11] Literature also demonstrates the importance of sex for understanding immigrant inequalities. It was found that women are often more likely to experience barriers to accessing care than men.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the hospital is often the only or the main point of access to healthcare services in many immigrants' countries of origin [5,12]. Furthermore,studies in countries with insurance-based healthcare systems con rm that immigrants have greater di culty accessing care, leading to greater use of acute care [11]. It can be hypothesized that immigrants are not always aware of other healthcare resources or facilities, probably because navigating the complex bureaucracy, compounded by language barriers, makes the service inaccessible [5].…”

Section: Discussionmentioning

confidence: 99%

The neurosurgical immigrant experience in Italy: analysis of a northeast tertiary center.

Giordan,

Marton,

Canova

2023

Preprint

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Introduction: Italy’s immigrant population has risen for the last two decades. Integration into society, including access to healthcare, is critical for the well-being of these individuals. We analyzed two groups: regular immigrants and Italians, to determine whether immigrant and native Italian populations receive different care. Methods: inpatient and outpatient medical records were collected from January 2017 to December 2021. We abstracted: identification code, nationality, sex, age, ICD-9 codes, date of the first visit, date of additional visits, and data on surgical intervention. ICD-9 codes were utilized to categorize patients based on their pathologies. Patients were grouped according to their geographical origin: European Union (EU), Central and Eastern Europe, North, Central, and South Africa, and North and Central and South America. Results: more patients from Asia and Africa presented to inpatient than outpatient clinics (p-value: 0.001). Median age was lower for Asian and Eastern European patients than EU ones. More patients presented with acute spine pain (p-value: 0.001) as inpatients, while outpatients presented more for degenerative spine issues (p-value: <0.001) but less for brain neoplasms (p-value: 0.009). Additional visit rates were higher for immigrants than Italians (IRR 1.32 visit- year, 95% CI 0.99–1.77 visits - year, p-value: 0.06), especially when spinal and younger patients. Conclusions: access to emergency care and additional visits was more prevalent in the recent immigrant population, especially from Asia, reflecting unconsolidated health habits. Immigrants from Central and Eastern Europe or North Africa seem fully integrated.

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Comparison of End-of-Life Care Between Recent Immigrants and Long-standing Residents in Ontario, Canada

Cited by 7 publications

References 45 publications

Medical Travel for Immigrant Patients With Cancer—Returning Home

Medical Travel for Immigrant Patients With Cancer—Returning Home

Inequities in access to palliative and end-of-life care in the black population in Canada: a scoping review

The neurosurgical immigrant experience in Italy: analysis of a northeast tertiary center.

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