Exploring continuity of care at the end of life

Michelle Howard received two CIHR grants (2018, 2022) to explore end-of-life care patterns in relation to the continuity of physician care for people dying in Ontario, Canada. The first grant used population-based health administrative data at the Institute for Clinical Evaluative Sciences (ICES) and has resulted in a publication in CMAJ Open that describes the volume and mix of outpatient physician care over the last year of life. Another publication in Cancer Medicine describes settings of care in the last 100 days of life for cancer decedents. Furthermore, there is one manuscript in-press at CMAJ Open and one manuscript being submitted to Palliative Medicine.

The second grant will support a mixed-methods sequential explanatory design with four phases. Phase 1 will be a population-based retrospective cohort study through ICES. Phase 2 will be a design installation serving as a public consultation through participatory art. Phase 3 will be a qualitative study that develops a theory of continuity of care at the end of life. Phase 4 will involve knowledge translation and a refined design installation.