A Comparative Analysis of Potential Spatio-Temporal Access to Palliative Care Services in Two Canadian Provinces

Peer reviewed: 
Yes, item is peer reviewed.
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Final version published as: 

Schuurman N, Amram O, Crooks VA, Johnston R, Williams A. A comparative analysis of potential spatio-temporal access to palliative care services in two Canadian provinces. BMC Health Serv Res. 2015 Jul 17;15:270. doi: 10.1186/s12913-015-0909-x.

Date created: 
Palliative care
Rural health
Health service access


Access to health services such as palliative care is determined not only by health policy but a number of legacies linked to geography and settlement patterns. We use GIS to calculate potential spatio-temporal access to palliative care services. In addition, we combine qualitative data with spatial analysis to develop a unique mixed-methods approach.


Inpatient health care facilities with dedicated palliative care beds were sampled in two Canadian provinces: Newfoundland and Saskatchewan. We then calculated one-hour travel time catchments to palliative health services and extended the spatial model to integrate available beds as well as documented wait times.


26 facilities with dedicated palliative care beds in Newfoundland and 69 in Saskatchewan were identified. Spatial analysis of one-hour travel times and palliative beds per 100,000 population in each province showed distinctly different geographical patterns. In Saskatchewan, 96.7 % of the population living within a-1 h of drive to a designated palliative care bed. In Newfoundland, 93.2 % of the population aged 65+ were living within a-1 h of drive to a designated palliative care bed. However, when the relationship between wait time and bed availability was examined for each facility within these two provinces, the relationship was found to be weak in Newfoundland (R2 = 0.26) and virtually nonexistent in Saskatchewan (R2 = 0.01).


Our spatial analysis shows that when wait times are incorporated as a way to understand potential spatio-temporal access to dedicated palliative care beds, as opposed to spatial access alone, the picture of access changes.

Document type: 
Canadian Institutes of Health Research (CIHR)
Michael Smith Foundation for Health Research (MSFHR)