Examining the spatial accessibility of palliative care services in British Columbia: recommendations for providing care in BC’s rural and remote regions

An increased need for palliative care services (PCS) has been acknowledged worldwide as the populations of many countries age. Despite this, implementation of PCS has been piecemeal in many jurisdictions. Canadian end-of-life care frameworks are beginning to address this shortcoming; however, they have largely failed to consider the challenges of delivery in rural and remote regions. This thesis examines the spatial accessibility of PCS in British Columbia (BC), and introduces the concept of palliative care hubs (PCH) for delivery in BC’s under-populated regions. Spatial analysis techniques are used to identify communities that are outside of primary PCH service catchments, the proportion of the population of each Health Authority considered to be without spatial access, and the suitability of regional communities as sites for new secondary PCHs. Implementation of hubs in the most suitable communities could provide residents of surrounding regions with enhanced access to appropriate, multidisciplinary PCS at the end-of-life.