Home death is associated with frequency of physician home medical care visits: A questionnaire survey on communications in home medical care settings

Abstract

The frequency of doctor home-visits was the only factor identified that was positively associated with the occurrence of home death in home medical care settings.

Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study

“…The differences observed could be due to several reasons, including adjustment for confounders, and differences in the base population and health care system (i.e., intervention) studied; only 1 previous study was conducted in Canada[ 27 ], with the others being conducted in Denmark[ 28 , 29 , 32 ] and Japan. [ 26 , 30 , 31 ].…”

“…The relationship between physician home visits and place of death is complex, influenced by the characteristics of the patient, the level of supports at home, and health system factors such as the mix of available hospital and community services. [ 26 – 32 ] We adjusted for many, but not all, of these variables. Notably, we could not consider the presence of a caregiver in the home, since we did not have access to such data at a population level.…”

“…At least seven studies have examined the association between physician home visits and place of death, with all suggesting an increase in the likelihood of home deaths. [ 26 – 32 ] There are, however, limitations to these studies, hampering the overall strength of the evidence and the ability to make policy recommendations. Five of the studies, for example, examined only cancer patients (n = 92 to 4,092 deaths)[ 28 – 32 ], and the two that did not (n = 216 and 295) consisted only of decedents receiving home care.…”

“…Five of the studies, for example, examined only cancer patients (n = 92 to 4,092 deaths)[ 28 – 32 ], and the two that did not (n = 216 and 295) consisted only of decedents receiving home care. [ 26 , 27 ] None examined all deaths at a population level, and none controlled for a full set of potentially influential confounders, including level of morbidity and the concurrent delivery of home care. Furthermore, previous studies did not address potential indication bias; that those receiving home visits are necessarily at home, and that those at home (especially near the end-of-life) in turn have a higher chance of dying at home.…”

Factors related to the provision of home-based end-of-life care among home-care nursing, home help, and care management agencies in Japan

“…Patient-related and provider-related factors of home-based EOL care have been revealed in previous studies: patients’ low functional status [ 10 , 11 ], living with relatives [ 10 ], patients and/or family preference [ 12 – 14 ], home care and its intensity [ 10 ], the frequency of physicians’ home visits [ 15 ], and affiliation of the attending physician [ 13 ]. Meanwhile, it has not been clear which characteristics of home-care agencies were associated with the possibility of providing EOL care, nor whether there is a difference in the associated characteristics among different types of home-care agencies.…”