Pallium pushes palliative care's economic benefits

Pallium Canada is calling for a different approach to medical care, one that in the long run could prove economically beneficial.

The national charitable organization, focused on improving the quality and accessibility of palliative care, explained why additional federal investment in long-term care facilities could be "a practical investment" during an Oct. 5 press conference on Parliament Hill.

Specifically, the non-profit calls for $300 million to develop and implement a national palliative care training standard for long-term care. The goal is to formulate a coast-to-coast baseline for personal support workers, nurses and physicians on what constitutes quality continuing care. Armed with that framework, enactment could be sensibly adapted to fit the needs of provinces, communities and individual residences.

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Pallium Canada also envisions that some of the proposed investment could bolster training time, staff backfill capacity, ongoing mentorship opportunities, practical support and program evaluation resources.

“Canada does not need to choose between better care and a more productive health system,” said Pallium Canada CEO Jeff Moat. “When long-term care teams are equipped to provide a palliative approach earlier, residents can receive more appropriate care where they live, families can better understand what to expect and hospitals can be used when they are truly needed. This is a practical investment in the health-care workforce and capacity that Canada already has.”

The organization published an evidence brief titled “The Economic Case for Investing in Palliative Care Workforce Readiness” to support its stance.

Citing 2023 data from the Canadian Institute for Health Information (CIHI) indicating that 61 per cent of Canadians with palliative care needs only receive that attention while in hospital, Pallium Canada suggests that earlier palliative-care intervention can prevent avoidable hospital transfers and reduce health system costs.

CIHI found in 2021-2022 that “patients supported by palliative home care spent fewer days on average in hospital in the last year of their lives compared with those who received palliative care only in hospital (18 days versus 28 days, respectively).” Additionally, “only 11 per cent of people receiving palliative home care had life-saving interventions, compared with 26 per cent among people not getting palliative home care.”

Dr. Amit Arya appeared at the press conference with Moat and Pallium Canada’s board chair Christine Power and complemented the statistical findings about earlier palliative-care intervention with his first-hand testimony as a palliative-care physician at Toronto's North York General Hospital.

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“When palliative care is initiated early, the whole experience of care changes,” said Arya. “Symptoms such as pain, shortness of breath and anxiety are recognized and managed sooner, resulting in residents being more comfortable and having an improved quality of life. Families and residents are better supported in making decisions about medical treatment and hospital transfers guided by the resident’s wishes.

“In all my frontline work in long-term care, I have seen when staff do not have the education, skills and tools needed to provide palliative care, care often becomes reactive and crisis-driven.” 

The evidence brief also spotlighted CIHI’s finding about how few people had palliative care access. According to CIHI’s research, just 19 per cent of Canadians who passed away in long-term care homes in 2021-2022 were receiving palliative care in their last year of life. While this signifies a 300-per-cent increase from six per cent in 2016-2017, Pallium Canada sees significant runway for strengthening the system.

Pallium Canada’s economic case also champions a 2026 report from the professional services firm Deloitte Canada that suggests national leadership treats “health as a productivity asset.”

Deloitte Canada noted that Canada’s productivity in GDP per hour worked was US $59.40 in 2024, a figure that trails its American counterparts USD $84.11 per hour worked by 30 per cent.

Suggesting a correlation, the firm highlighted that the “share of adults reporting very good or excellent mental health fell from 72.4 per cent in 2015 to 59 per cent in 2021 with the steepest drop among young adults aged 18 to 34.” Regarding overall health, “after holding steady for two decades, the share of adults reporting very good or excellent health fell from 68.6 per cent to 56.4 per cent between 2015 and 2024, with the sharpest decline again among young adults aged 18 to 34.”  The study also indicated that referral to treatment wait times tripled from 9.3 weeks in 1993 to 28.6 weeks in 2025.

Of the projected $105 billion economic output lost in caregiving, morbidity and mortality costs in 2025, echoing Pallium Canada’s early intervention ethos, Deloitte suggests $25 billion of that sum is recoverable by making investments that prevent non-communicable disease rather than treating illness. Caregiving, morbidity and mortality costs would scale downward, the study asserted.

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“Yet Canada’s system remains biased toward downstream care,” stated the report. “According to the Canadian Institute for Health Information (CIHI), over half of total health spending in 2025 will flow to hospitals (26 per cent), physicians (13.8 per cent) and drugs (13.3 per cent). Most productivity, however, is gained or lost long before acute care is needed.”

See pallium.ca.

(Amundson is an associate editor and writer for The Catholic Register.)