International study of the place of death of people with cancer: a population-level comparison of 14 countries across 4 continents using death certificate data

Cohen, Joachim; Pivodic, Lara; Miccinesi, Guido; Onwuteaka-Philipsen, Bregje D.; Naylor, Wayne; Wilson, Donna M.; Loučka, Martin; Csikós, Ágnes; Pardon, Koen; Block, Lieve Van den; Ruíz-Ramos, Miguel; Cardenas-Turanzas, M; Rhee, YongJoo; Aubry, Régis; Hunt, Katherine; Teno, Joan M.; Houttekier, Dirk; Deliens, Luc

doi:10.1038/bjc.2015.312

Cited by 167 publications

(167 citation statements)

References 22 publications

Supporting

Mentioning

153

Contrasting

Unclassified

Order By: Relevance

“…19 Patients dying at home may have unintended consequences for caregivers, such as deterioration in physical health, inability to return to work, and protracted grief. 2,19,20 Further research is needed to establish whether the involvement of PC shifts care from institutions to home, or whether dying at home is better than dying in a hospital. 2,19 The limited evidence for benefits of one location over another, combined with the substantial proportion of patients who prefer to die in settings outside the home, suggests that although investment in services such as home PC may help reduce the burden on hospitals and inpatient hospices, improvements in EOL care should continue across all care settings.…”

Section: Discussionmentioning

confidence: 99%

“…9 There is variation between studies in the proportion of people who prefer to be cared for at home (25%-87%) or in a hospice (9%-30%) at EOL. 2 Despite hospitals being the most common place of death in many countries, few choose to be cared for in these facilities. 2 Home care is also highly valued by informal carers (25%-64%).…”

mentioning

confidence: 99%

“…2 Despite hospitals being the most common place of death in many countries, few choose to be cared for in these facilities. 2 Home care is also highly valued by informal carers (25%-64%). 10 Patients who are older (age ≥55 y), female, single, and of a higher socioeconomic status have been found to prefer hospice care, whereas those who are younger, male, of better physical health, and of poorer mental health have been found to prefer home care.…”

mentioning

confidence: 99%

“…11 However, few studies have explored how patients formulate preferences in order to choose one location over another. 2 In one US study of terminally ill patients with cancer, perceived quality of life, the availability and capacity of family carers, the impact their choice would have on others, and quality of healthcare were major considerations in preference. 12 Greater understanding of patient choices and the underlying reasons for these choices can help inform the development of more effective, patientcentered care models that may be more widely available and integrated across care settings.…”

mentioning

confidence: 99%

“…12 Greater understanding of patient choices and the underlying reasons for these choices can help inform the development of more effective, patientcentered care models that may be more widely available and integrated across care settings. 2 To do this, patients must be given opportunities to articulate and implement their choice through proper discussions with key individuals, including healthcare providers and support persons. When patients' preferences are known, their likelihood of dying in the location of their choice may be enhanced.…”

mentioning

confidence: 99%

See 4 more Smart Citations

The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care

Waller¹,

Sanson‐Fisher²,

Zdenkowski³

et al. 2018

J Natl Compr Canc Netw

View full text Add to dashboard Cite

Background: Helping people achieve their preferred location of care is an important indicator of quality end-of-life (EOL) care. Using a sample of Australian medical oncology outpatients, this study examined (1) their preferred location of EOL care; (2) their perceived benefits and worries of receiving care in that location; (3) the percentage who had discussed preferences with their doctor and/or support person; and (4) whether they wanted their doctor to ask them where they wanted to die. Methods: Adults with a confirmed diagnosis of cancer were approached between September 2015 and January 2016 in the waiting room of an Australian oncology outpatient clinic. Consenting participants completed a home-based pen-and-paper survey indicating preferred location of care, perceived benefits and worries of that location, whether they had discussed preferences with their doctors, and whether they were willing to be asked about their preferences. Results: A total of 203 patients returned the survey (47% of those eligible). Less than half preferred to be cared for at home (47%), 34% preferred a hospice/palliative care unit, and 19% preferred the hospital. Common benefits and worries associated with locations included perceived burden on others, familiarity of environment, availability of expert medical care, symptom management, and likelihood of having wishes respected. More patients had discussed preferences with their support persons (41%) than doctors (7%). Most wanted a doctor to ask them about preferred location of care (87%) and thought it was important to die in the location of their choice (93%). Conclusions: Patients were willing to have clinicians to ask them where they wanted to die, although few had discussed their preferences with doctors. Although home was the most preferred location for many patients, the overall variation suggests that clinicians should adopt a systematic approach to eliciting patient preferences. J Natl Compr Canc Netw 2018;16(1):35-41 doi: 10.6004/jnccn.2017.7025 Research into location of end-of-life (EOL) care offers insight into whether people are accessing resources that aim to improve quality of dying and support appropriate service planning. 1 A recent population-level study of patients with cancer in 14 countries reported that between 12% and 57% of patients die at home and between 22%

show abstract