A Study on Locations of Death and Factors Associated with Death among Cancer Patients in South Korea

Abstract

Background: Location of death has been used to examine an indicator for good death. This study aims to examine location of death among patients with three major cancers (gastric, liver, and lung) and other factors associated with location of death in South Korea. Methods: We selected the medical and pharmacy claims data for health services and location of death among the 42,596 decedents with cancer (lung 16,632, liver 15,872, gastric 10,092) from 2009 to 2013. We used logistic regressions to identify factors associated with home death. Outcome measures are locations of death (hospital, outpatient clinics or emergency room and home). Results: Only 8.9% died at home whereas 46.5% died in hospital as inpatients. Patients with more than one comorbid cancer or receivers for any supportive care were significantly more likely to die in hospital. Female and younger than 55 years old liver cancer patients were associated with home death. Patients living in metropolitan area, or paying more insurance premium, or being public aid beneficiaries, were associated with home death. Conclusions: The supportive care service use prior to death was significantly associated with increasing odds to hospital death. Being older than 75, or having multiple cancers was significant factors associated with hospital death, whereas living in metropolitan area, lower income or emergency visit were significant factors with home death. These findings are opposite to what is found, as the palliative care and hospice is predominantly hospital-centered. The findings emphasize a need to available end-of-life care in community for dying patients.

Preferred versus Actual Place of Care and Factors Associated with Home Discharge among Korean Patients with Advanced Cancer: A Retrospective Cohort Study

“…Previous studies have reported that there was no correlation between sex [ 24 , 25 , 26 ] and the preferred place of care. However, another study reported that female patients with cancer were more likely to be discharged home than male patients [ 10 ]. In line with these findings, our study found that female patients were more likely to be discharged home.…”

“…A meta-analysis reported that 50–90% of patients with cancer wished to be cared for or die at home [ 9 ]. However, 87.2% of patients with terminal cancer spent time in a hospital at the EOL [ 10 ]. To respect the patient’s preference, it is important to know the barriers against achieving care at home at the EOL.…”