Exploring the Definitions of Physician-Delivered Palliative Care in Canada: A Narrative Review.

Abstract

Background: Palliative care is essential yet underutilized in Canada. Inconsistent definitions and fee codes across provinces/territories hinder effective comparative analysis. Aim: Explore palliative care definitions and fee codes in Canada by examining the provincial/territorial schedules of benefits. Design: We conducted a narrative review of provincial/territorial schedules of benefits, focusing on palliative care definitions and fee codes. Qualitative comparative analysis was performed on the definitions, and descriptive statistical analysis was conducted on the fee codes. Setting/Participants: The study reviewed schedules of benefits from 11 Canadian provinces and territories, excluding Quebec and Nunavut. Results: About 7/11 (64%) provinces/territories published definitions for palliative care, typically characterizing it as terminal, focusing on comfort, and providing a time-based prognosis. The number of specific palliative care fee codes varied from 4 to 32. Conclusions: There is substantial variability in the definition and fee codes used for physician-delivered palliative care across Canada. A standardized national framework for palliative care definitions and fee codes could improve access and care delivery.