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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Palliative Care 1/2015

Going back to home to die: does it make a difference to patient survival?

Zeitschrift:
BMC Palliative Care > Ausgabe 1/2015
Autoren:
Nozomu Murakami, Kouichi Tanabe, Tatsuya Morita, Shinichi Kadoya, Masanari Shimada, Kaname Ishiguro, Naoki Endo, Koichiro Sawada, Yasunaga Fujikawa, Rumi Takashima, Yoko Amemiya, Hiroyuki Iida, Shiro Koseki, Hatsuna Yasuda, Tatsuhiko Kashii
Wichtige Hinweise
Nozomu Murakami and Kouichi Tanabe contributed equally to this work.

Competing interest

The authors declare that they have no competing interests.

Authors’ contributions

NM, KT, TM, and TK designed the study. KT and TM performed analysis and data interpretation. NM and KT drafted and revised the manuscript. NM, KT, SK, MS, KI, NE, KS, YF, RT, YA, HI, and SK contributed to data collection. HI, SK, and HY commented on the results and discussion, and contributed to improving the manuscript. TK led the study and organized the authors’ conclusion. All authors contributed to the manuscript, reviewed drafts, and approved the final content.

Abstract

Background

Many patients wish to stay at home during the terminal stage of cancer. However, there is concern that medical care provided at home may negatively affect survival. This study therefore explored whether the survival duration differed between cancer patients who received inpatient care and those who received home care.

Methods

We retrospectively investigated the place of care/death and survival duration of 190 cancer patients after their referral to a palliative care consultation team in a Japanese general hospital between 2007 and 2012. The patients were classified into a hospital care group consisting of those who received palliative care in the hospital until death, and a home care group including patients who received palliative care at home from doctors in collaboration with the palliative care consultation team. Details of the place of care, survival duration, and patient characteristics (primary site, gender, age, history of chemotherapy, and performance status) were obtained from electronic medical records, and analyzed after propensity score matching in the place of care.

Results

Median survival adjusted for propensity score was significantly longer in the home care group (67.0 days, n = 69) than in the hospital care group (33.0 days, n = 69; P = 0.0013). Cox’s proportional hazard analysis revealed that the place of care was a significant factor for survival following adjustment for covariates including performance status.

Conclusions

This study suggests that the general concern that home care shortens the survival duration of patients is not based on evidence. A cohort study including more known prognostic factors is necessary to confirm the results.
Literatur
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