Congruence between Preferred and Actual Place of Death for Those in Receipt of Home-Based Palliative Care

Cai, Jiaoli; Zhang, Li; Guerriere, Denise N.; Coyte, Peter C.

doi:10.1089/jpm.2019.0582

Cited by 33 publications

(29 citation statements)

References 34 publications

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“…Moreover, only 12% of the patients with COPD and 9% of those with LC who had access to SPC died at acute hospitals, compared to 45% and 58%, respectively, of those who did not have access, implying that SPC unburdens acute hospital care. This is a question of quality, as many patients prefer home as their place of death [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic obstructive pulmonary disease and lung cancer: access to palliative care, emergency room visits and hospital deaths

et al. 2021

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Background Despite the severe symptoms experienced by dying COPD patients, specialized palliative care (SPC) services focus mainly on cancer patients. We aimed to study the access to SPC that COPD and lung cancer (LC) patients receive and how that access affects the need for acute hospital care. Methods A descriptive regional registry study using data acquired through VAL, the Stockholm Regional Council’s central data warehouse, which covers nearly all healthcare use in the county of Stockholm. All the patients who died of COPD or LC from 2015 to 2019 were included. T-tests, chi-2 tests, and univariable and multivariable logistic regression analyses were performed on the accumulated data. Results In total, 6479 patients, (2917 with COPD and 3562 with LC) were studied. The patients with LC had more access to SPC during the last three months of life than did those with COPD (77% vs. 18%, respectively; p < .0001), whereas patients with COPD were more likely to be residents of nursing homes than those with LC (32% vs. 9%, respectively; p < .0001). Higher socioeconomic status (SES) (p < .01) and patient age < 80 years (p < .001) were associated with increased access to SPC for LC patients. Access to SPC correlated with fewer emergency room visits (p < .0001 for both COPD and LC patients) and fewer admissions to acute hospitals during the last month of life (p < .0001 for both groups). More COPD patients died in acute hospitals than lung cancer patients, (39% vs. 20%; χ2 = 287, p < .0001), with significantly lower figures for those who had access to SPC (p < .0001). Conclusions Compared to dying COPD patients, LC patients have more access to SPC. Access to SPC reduces the need for emergency room visits and admissions to acute hospitals.

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Section: Discussionmentioning

confidence: 99%

Chronic obstructive pulmonary disease and lung cancer: access to palliative care, emergency room visits and hospital deaths

et al. 2021

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“…Patients' preferences for the place of death have been examined in various countries or regions, such as China [8], Egypt [9], Netherlands [10], Denmark [4,11], Japan [7], UK [3,12], Canada [13,14], and Taiwan [15] and these studies indicate that most patients preferred to die at home. Some of these studies have identified the determinants of preferred place of death [7][8][9]11,15].…”

Section: Introductionmentioning

confidence: 99%

Where Do Cancer Patients in Receipt of Home-Based Palliative Care Prefer to Die and What Are the Determinants of a Preference for a Home Death?

Cai

Zhang

Guerriere

et al. 2020

IJERPH

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Understanding the preferred place of death may assist to organize and deliver palliative health care services. The study aims to assess preference for place of death among cancer patients in receipt of home-based palliative care, and to determine the variables that affect their preference for a home death. A prospective cohort design was carried out from July 2010 to August 2012. Over the course of their palliative care trajectory, a total of 303 family caregivers of cancer patients were interviewed. Multivariate regression analysis was employed to assess the determinants of a preferred home death. The majority (65%) of patients had a preference of home death. The intensity of home-based physician visits and home-based personal support worker (PSW) care promotes a preference for a home death. Married patients, patients receiving post-graduate education and patients with higher Palliative Performance Scale (PPS) scores were more likely to have a preference of home death. Patients reduced the likelihood of preferring a home death when their family caregiver had high burden. This study suggests that the majority of cancer patients have a preference of home death. Health mangers and policy makers have the potential to develop policies that facilitate those preferences.

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“…Subsequently, patients are more likely to die at home. Cai et al [ 23 ]. reported similar findings for cancer patients in Canada that more home-based nursing visits in the community could increase the congruence between the preferred and actual places of death, with the home being the most preferred place of death.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Survival, Place of Death, and Medical Utilization of Terminal Patients Receiving Hospital-Based and Community-Based Palliative Home Care: A Retrospective and Propensity Score Matching Cohort Study

Lin

Tsay

Chang

et al. 2021

IJERPH

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Evidence shows that community-based palliative home care (PHC) provision enhances continuous care and improves patient outcomes. This study compared patient survival, place of death, and medical utilization in community- versus hospital-based PHC. A retrospective cohort study was conducted of patients aged over 18 referred to either community- or hospital-based PHC from May to December 2018 at a tertiary hospital and surrounding communities in Southern Taiwan. A descriptive analysis, Chi-square test, t-test, and Log-rank test were used for the data analysis of 131 hospital-based PHC patients and 43 community-based PHC patients, with 42 paired patient datasets analyzed after propensity score matching. More nurse visits (p = 0.02), fewer emergency-room visits (p = 0.01), and a shorter waiting time to access PHC (p = 0.02) were found in the community group. There was no difference in the duration of survival and hospitalization between groups. Most hospital-based patients (57%) died in hospice wards, while most community-based patients died at home (52%). Community-based PHC is comparable to hospital-based PHC in Taiwan. Although it has fewer staffing and training requirements, it is an alternative for terminal patients to meet the growing end-of-life care demand.

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Congruence between Preferred and Actual Place of Death for Those in Receipt of Home-Based Palliative Care

Cited by 33 publications

References 34 publications

Chronic obstructive pulmonary disease and lung cancer: access to palliative care, emergency room visits and hospital deaths

Chronic obstructive pulmonary disease and lung cancer: access to palliative care, emergency room visits and hospital deaths

Where Do Cancer Patients in Receipt of Home-Based Palliative Care Prefer to Die and What Are the Determinants of a Preference for a Home Death?

A Comparison of the Survival, Place of Death, and Medical Utilization of Terminal Patients Receiving Hospital-Based and Community-Based Palliative Home Care: A Retrospective and Propensity Score Matching Cohort Study

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