Supporting Cancer Patients Dying at Home or at a Hospital for Taiwanese Family Caregivers

2009 ◽  
Vol 32 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Siew Tzuh Tang
2010 ◽  
Vol 26 (2) ◽  
pp. 78-87 ◽  
Author(s):  
Anita Mehta ◽  
S. Robin Cohen ◽  
Franco A. Carnevale ◽  
Hélène Ezer ◽  
Francine Ducharme

2012 ◽  
Vol 32 (4) ◽  
pp. 4_41-4_51
Author(s):  
Hiromi Kobayashi ◽  
Takashi Nakaya ◽  
Michiko Moriyama

2018 ◽  
Vol 56 (6) ◽  
pp. 962-974 ◽  
Author(s):  
Eleanor Wilson ◽  
Glenys Caswell ◽  
Nicola Turner ◽  
Kristian Pollock

Cancer ◽  
2016 ◽  
Vol 122 (9) ◽  
pp. 1453-1460 ◽  
Author(s):  
Jun Hamano ◽  
Takashi Yamaguchi ◽  
Isseki Maeda ◽  
Akihiko Suga ◽  
Takayuki Hisanaga ◽  
...  

2020 ◽  
Author(s):  
Yakir Rottenberg ◽  
Gil Goldzweig ◽  
Adir Shaulov

Abstract Background: Most cancer patients want to die at home; however, many die in hospital. The aim of the current study is to elucidate the correlation between dying at home and various personal factors in the Israeli population of cancer patients.Methods: Data on cancer incidence (2008-2015) and death (2008-2017) was provided by the Israeli Central Bureau of Statistics and the Israel National Cancer Registry. Binary logistic regression analyses were performed to assess odds ratios for death at home following cancer diagnosis while controlling for age, sex, ethnicity, years of education, residential socioeconomic score, and time from diagnosis. We also assessed the relation between place of death and specific cancer sites, as well as the time trend from 2008-2017.Results: About one quarter (26.7%) of the study population died at home. Death at home was most frequent among patients diagnosed with brain tumors (37.0%), while it was the lowest among patients with hematologic malignancies (lymphoma and leukemia, 20.3% and 20.0%, respectively). Rates of dying at home among patients with residential socioeconomic scores of 1, 2-9, and 10 were about 15%, 30%, and 42.9%, respectively. In patients from the 4th to the 7th decades of life, rates of death at home increased at a linear rate that increased exponentially from the 8th decade onwards. After controlling for potential confounders, predictive variables for death at home included age (HR=1.020 per year), male sex (HR=1.18), years of education (HR=1.029 per year), and time from diagnosis (HR=1.003 per month, all p<0.001). No trend was seen from 2008-2013, while from 2014-2017 a slight increase in the rate of death at home was seen each year.Conclusions: These results indicate that inequality exists among cancer patients in Israel regarding the opportunity to die at home. The present findings stress the importance of delivering efficient palliative care at home, mainly for patients with hematologic malignancies, younger patients, and patients of very low socioeconomic statuses. Understanding the complex mechanisms whereby patient preferences and the above variables may determine the preferred place of death remains an important research priority.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6502-6502
Author(s):  
Laura Elizabeth Panattoni ◽  
Li Li ◽  
Qin Sun ◽  
Catherine R. Fedorenko ◽  
Hayley Sanchez ◽  
...  

6502 Background: The COVID-19 pandemic dramatically reduced family access to hospitals and created new barriers to home hospice care, raising concerns about how the pandemic has impacted cancer patients’ place of death and end of life home hospice support. Hypothesizing that Medicaid-enrolled cancer patients may be at greater risk of disruptions in end-of-life care compared to commercially insured patients, we examined changes in place of death and home hospice support for Medicaid and Commercial enrollees following the pandemic. Methods: We linked WA State cancer registry records with claims from Medicaid and approximately 75% of commercially insured cancer patients in the state. Patients ages 18-64 with solid-tumor malignancies who died March-June 2020 (COVID) were compared to those who died March-June 2017-2019 (Pre-COVID). Place of death was categorized as hospital, home with hospice, and home without hospice; nursing home deaths were excluded. Given our sample size, we examined differences in the likelihood of place of death with Fisher’s exact tests and multinomial logistic regressions stratified by payer and by COVID period, controlling for age, gender, race, stage, cancer type, and census tract-level neighborhood deprivation. We report marginal effects. Results: In Fisher’s exact analyses, Medicaid but not commercial patients were significantly less like to die in hospital and more likely to die at home without hospice during COVID (Table). In pre-post adjusted analysis of Medicaid patients, the probability of dying in the hospital was 12.3% (p=0.03) percentage points lower during the pandemic versus before, while the probability of dying at home without hospice was 11.1% (p=0.04) greater. Place of death did not change significantly pre-post for commercial patients. In addition, Pre-COVID, the probability of dying in the hospital was 10.7% (p=0.03) greater for Medicaid than commercial patients. During COVID, the probability of dying at home without hospice was 15.8% (p=0.04) greater for Medicaid versus commercial patients but lower for women (ME=20.2%; p=0.01) and colorectal versus breast cancer patients (ME=39.2%; p=0.01). Conclusions: Following COVID, Medicaid patients place of death shifted from hospital to homes, but without an increase in the use of home hospice services. In contrast, place of death and hospice use among commercial patients did not significantly change. This widening disparity in home deaths without hospice services raises concerns that the pandemic disproportionately worsened end of life experience for low income patients with cancer.[Table: see text]


2014 ◽  
Vol 13 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Frida Barak ◽  
Sofia Livshits ◽  
Haana Kaufer ◽  
Ruth Netanel ◽  
Nava Siegelmann-Danieli ◽  
...  

AbstractObjective:Most patients prefer to die at home, but barely 30% do so. This study examines the variables contributing to dying at home.Methods:The participants were 326 cancer patients, of both genders, with a mean age of 63.25 years, who died from 2000 to 2008 and were treated by the palliative care unit of the Barzilai Hospital. Some 65.7% died at home and 33.4% in a hospital. The data were extracted from patient files. The examined variables were demographic (e.g., age, gender, marital status, ethnic background, number of years in Israel until death), medical (e.g., age at diagnosis, diagnosis, nature of last treatment, patient received nursing care, patient given the care of a social worker, patient had care of a psychologist, family received care of a social worker, patient had a special caregiver), and sociological (e.g., having insurance, having worked in Israel, living alone or with family, living with one's children, living in self-owned or rented house, family members working).Results:The findings indicate that the chances of dying at home are higher if the patient is non-Ashkenazi, the family got social worker care, the patient lived in a self-owned house, the patient lived with his family, the family members worked, and the patient's stay in Israel since immigration was longer. Logistic regression showed that all the predictors together yielded a significant model accounting for 10.9–12.3% of the variance.Significance of results:The findings suggest that dying at home requires maintaining continued care for the patient and family in a community context.


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