Palliative care delivery in the last year of life among ethnically South Asian Canadians in Ontario, Canada

Ethnically South Asian (SA) adults in North America frequently experience unmet needs at the end of life, yet their use palliative care (PC) services is unknown. To describe the trend and models of PC delivery in the last year of life amongst ethnically SA adults in Ontario, Canada. Population-based cohort study using linked health administrative data of all adults who died between January 1st, 2012, and October 31st, 2022 in Ontario, Canada. Ethnically SA adults were identified using a validated surname-based algorithm (Specificity = 99.7%). The primary outcome was the model of PC delivery (no PC, generalist PC, specialist PC, mixed- generalist/specialist PC). The final cohort included 15,745 ethnically SA adults (54.8% male, 73.8 mean age (SD 15.4). The proportion of ethnically SA adults receiving any PC in the last year of life increased from 46.9% in 2012 to 56.8% in 2022. The proportion of SA patients receiving specialist (8.9% to 17.2%) or mixed PC (13.7% to 21.4%) increased, while the proportion receiving generalist PC decreased (24.3% to 18.2%). The proportion of ethnically SA patients receiving specialist or mixed PC increased over the last decade. This trend may reflect growing awareness of PC and medical and sociocultural complexity. Additional research is needed to understand the impact of current PC services on ethnically SA patients and their care partners.