Article Figures & Tables
Figures
- Figure 1:
Flow chart for the creation of the cohort. Note: OHIP = Ontario Health Insurance Plan, ORGD = Ontario Registrar General — Deaths database.
- Figure 2:
Distribution of outpatient physician continuity of care in the last 12 months of life among patients who died in Ontario from 2013 to 2018 (n = 417 627).
- Figure 3:
Multivariable associations between characteristics of patients who died in Ontario from 2013 to 2018 and higher scores of usual provider continuity of care (≥ 0.50) (n = 416 026). Note: CI = confidence interval, OR = odds ratio, Ref. = reference category.
- Figure 4:
Multivariable associations between characteristics of patients who died in Ontario from 2013 to 2018 and higher scores of Bice–Boxerman continuity of care (≥ 0.50) (n = 416 026). Note: CI = confidence interval, OR = odds ratio, Ref. = reference category.
- Figure 5:
Multivariable associations between characteristics of patients who died in Ontario from 2013 to 2018 and higher scores of sequential continuity of care (≥ 0.50) (n = 416 026). Note: CI = confidence interval, OR = odds ratio, Ref. = reference category.
Tables
- Table 1:
Profile of patients aged 19 years or older who died between Jan. 1, 2013, and Dec. 31, 2018, in Ontario (excluding residents in long-term care and patients with less than the 2 outpatient encounters in the last year of life required to calculate continuity-of-care indices)
Patient characteristic No. (%)* of total cohort
n = 417 628UPC index, mean ± SD BICE index, mean ± SD SECON index, mean ± SD Age at death, yr 19–44 15 135 (3.6) 0.34 ± 0.30 0.30 ± 0.28 0.37 ± 0.29 45–54 23 472 (5.6) 0.33 ± 0.29 0.30 ± 0.26 0.36 ± 0.27 55–64 54 568 (13.1) 0.33 ± 0.27 0.28 ± 0.24 0.34 ± 0.26 65–74 85 907 (20.6) 0.33 ± 0.26 0.26 ± 0.22 0.33 ± 0.24 75–84 113 939 (27.3) 0.37 ± 0.26 0.29 ± 0.23 0.35 ± 0.25 85–94 106 471 (25.5) 0.42 ± 0.29 0.35 ± 0.27 0.41 ± 0.29 ≥ 95 18 136 (4.3) 0.48 ± 0.34 0.44 ± 0.32 0.51 ± 0.33 Missing 0 (0) Mean ± SD 74.9 ± 14.7 Median (IQR) 77 (66–86) Sex Female 192 595 (46.1) 0.38 ± 0.29 0.32 ± 0.26 0.39 ± 0.28 Male 225 033 (53.9) 0.37 ± 0.27 0.29 ± 0.24 0.35 ± 0.27 Missing 0 (0) Rural residence Urban 361 914 (86.7) 0.36 ± 0.28 0.30 ± 0.25 0.36 ± 0.27 Rural 54 575 (13.1) 0.43 ± 0.29 0.34 ± 0.27 0.39 ± 0.29 Missing 1139 (0.3) Neighbourhood income quintile 1 (lowest) 103 821 (24.9) 0.39 ± 0.29 0.32 ± 0.26 0.38 ± 0.28 2 92 275 (22.1) 0.37 ± 0.28 0.31 ± 0.25 0.37 ± 0.27 3 80 112 (19.2) 0.37 ± 0.28 0.30 ± 0.25 0.36 ± 0.27 4 70 952 (17.0) 0.37 ± 0.28 0.30 ± 0.25 0.36 ± 0.27 5 (highest) 68 866 (16.5) 0.35 ± 0.28 0.29 ± 0.24 0.36 ± 0.27 Missing 1602 (0.4) Cause-of-death category Terminal illness (e.g., cancer) 150 254 (36.0) 0.27 ± 0.23 0.23 ± 0.17 0.33 ± 0.21 Organ failure (e.g., CHF, COPD) 138 258 (33.1) 0.42 ± 0.29 0.33 ± 0.27 0.37 ± 0.29 Frailty (e.g., dementia) 82 888 (19.8) 0.44 ± 0.31 0.37 ± 0.29 0.40 ± 0.31 Sudden death 21 789 (5.2) 0.44 ± 0.31 0.37 ± 0.30 0.41 ± 0.32 Other 24 439 (5.9) 0.40 ± 0.29 0.32 ± 0.26 0.37 ± 0.29 Missing 0 (0) Illness history† Cancer 142 754 (34.2) 0.29 ± 0.24 0.25 ± 0.19 0.31 ± 0.22 CHF 99 307 (23.8) 0.40 ± 0.28 0.31 ± 0.25 0.36 ± 0.28 COPD 87 507 (21.0) 0.40 ± 0.28 0.32 ± 0.25 0.37 ± 0.27 Renal disease 63 976 (15.3) 0.34 ± 0.26 0.27 ± 0.22 0.31 ± 0.25 Number of prevalent conditions Tercile 1 (0–2) 155 219 (37.2) 0.36 ± 0.29) 0.31 ± 0.27 0.38 ± 0.28 Tercile 2 (3–4) 151 350 (36.2) 0.37 ± 0.28 0.31 ± 0.25 0.37 ± 0.27 Tercile 3 (5 or more) 111 059 (26.6) 0.38 ± 0.27 0.29 ± 0.23 0.34 ± 0.26 Mean ± SD 3.36 ± 2.00 Median (IQR) 3 (2–5) No. of outpatient physician visits in last year of life Quartile 1 (2–7) 102 388 (24.5) 0.48 ± 0.34 0.39 ± 0.35 0.43 ± 0.37 Quartile 2 (8–14) 108 828 (26.1) 0.41 ± 0.27 0.32 ± 0.23 0.38 ± 0.26 Quartile 3 (15–23) 98 484 (23.6) 0.34 ± 0.24 0.27 ± 0.19 0.34 ± 0.22 Quartile 4 (> 23) 107 928 (25.8) 0.26 ± 0.22 0.24 ± 0.18 0.33 ± 0.21 Mean ± SD 17.6 ± 13.7 Median (IQR) 14 (8–24) Note: BICE = Bice–Boxerman continuity of care, CHF = congestive heart failure, COPD = chronic obstructive pulmonary disease, IQR = interquartile range, SD = standard deviation, SECON = sequential continuity, UPC = usual provider continuity.
↵* Unless specified otherwise.
↵† Patient may have had these chronic diseases without dying from them, as captured in the end-of-life trajectory.
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