Predictors of Home Care Expenditures and Death at Home for Cancer Patients in an Integrated Comprehensive Palliative Home Care Pilot Program

Abstract

Facteurs de prévision des dépenses pour les soins à domicile et les décès à domicile chez les patients atteints du cancer dans le cadre d'un programme pilote de soins palliatifs complets à domicile

Factors Associated with Fulfilling the Preference for Dying at Home among Cancer Patients: The role of General Practitioners

“…Current literature notes that the presence of certain clinical factors, such as a hematological tumour (9,38) or the need for greater pain and symptom control, decrease one's likelihood of dying in one's preferred place (7). Social factors, such as medical costs and the burden placed on others, were cited as indicators of equitable access to palliative care services (8,39,40). For instance, some patients cannot afford even small out-of-pocket costs for palliative care services, and the availability of informal caregivers can vary.…”

The interaction of socioeconomic status with place of death: a qualitative analysis of physician experiences

“…Access to care in the home has also been associated with home death. Previous studies investigating the availability and utilization of home care and home visits found that patients were more likely to die at home or out of acute care if they lived in an area with more home hospice providers [ 10 ], received home care in the last 6 months of life [ 15 ], or received more nursing and personal support worker visits [ 6 , 16 , 17 ].…”

Reducing avoidable admissions in rural community palliative care: a pilot study of care coordination by General Practice registrars

“…Forward planning using instruments to measure functional status, combined with as needed home visits to pre‐empt crises provided a solid platform on which to deliver quality community palliative care. Better care coordination has been demonstrated to improve rates of home death in the international setting …”

“…The National Health and Hospitals Reform Commission recommends ‘ integrating multi‐disciplinary primary health care services…better coordination and continuity of care… [and] strengthening consumer…empowerment ’ . High‐quality end‐of‐life care involves managing multiple co‐morbidities, symptom control and ‘psychological, social, loss/grief, practical and end‐of‐life preparation’ . Strategies include:…”