TORONTO - A new study shows almost half of terminally ill cancer patients die in hospital, even though most people say they don't want to spend their final days in a health-care institution.

The study by the Canadian Institute for Health Information found that about 45 per cent of Canadian cancer patients died in hospital in 2011-2012, although rates varied among provinces.

About two-thirds of cancer deaths in Manitoba and New Brunswick occurred in hospital, compared to about two in five in Ontario and British Columbia.

CIHI says the availability of palliative care beds may differ from one province to another, and that could contribute to differences in rates of in-hospital deaths.

While most patients died in a hospital that had an intensive care unit, only 11 per cent were admitted to the ICU in their final two weeks of life and only eight per cent died there.

The study suggests some patients could have benefited from end-of-life care somewhere other than in a hospital and there could have been enough time to arrange for that alternate setting.

"Surveys have shown that most people — cancer patients included — do not want to die in a hospital. However, almost half of Canadian cancer patients are dying there," said Kathleen Morris, director of Health System Analysis and Emerging Issues at CIHI.

"This could be related to many factors, such as the availability of home care or hospice services. Provincial variations point to areas of needed improvement across the country."

The report also found that more than 80 per cent of patients had a documented palliative care diagnosis during their last hospital admission and palliative care was the main reason for hospitalization for more than half of all patients in the study.

However, it is not known what specific palliative care services were received or how many people may have had access to alternative palliative settings, such as hospice or home care.

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