Associations with the Japanese Population's Preferences for the Place of End-of-Life Care and Their Need for Receiving Health Care Services

Fukui, Sugao; Yoshiuchi, Kazuhiro

doi:10.1089/jpm.2012.0034

Cited by 14 publications

(14 citation statements)

References 32 publications

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“…The strengths of this study include the investigation of survival time as a primary end-point, and the adjustment for factors influencing prognosis (such as performance status). This study is also the first about this topic in Asian patients who typically prefer hospital rather than home care because of the concern that the latter could shorten their survival [ 11 , 12 ]. Our findings that the home care group had a significantly longer survival than the hospital care group could help to dispel unsubstantiated concerns about the negative effects of home care on patient survival.…”

Section: Discussionmentioning

confidence: 99%

“…Many Japanese people also believe that hospitals provide a higher quality of care than clinics; for example, parenteral hydration is a minimum requirement of hospitals even in patients whose death is imminent [ 11 ]. Patients and their families have often expressed concerns regarding the quality of home care, and many believe that it results in a potentially shorter survival during the terminal stage of cancer compared with hospital care [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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BackgroundMany 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.MethodsWe 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.ResultsMedian 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.ConclusionsThis 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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

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“…End of life care has been a very important issue worldwide. A substantial number of people desire to live and die in their own home (Fukui & Yoshiuchi, ; Gomes, Calanzani, Gysels, Hall, & Higginson, ). Several studies reported that fulfilling the person's wish of dying at home can increase the satisfaction of the patient and their family members (Gomes, Calanzani, Koffman, & Higginson, ; Yao et al, ).…”

Section: Introductionmentioning

confidence: 99%

Direct and indirect costs of home healthcare in Japan: A cross‐sectional study

Tomita

Hoshino

Kamiya³

et al. 2020

Health Soc Care Community

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To tackle the rising healthcare expenditure in an ageing society in Japan, home healthcare has been promoted over the past several years. However, there is a dearth of literature on total costs incurring for home healthcare. In this study, we conducted a cross‐sectional study among patients, who received home healthcare in the month of May, 2018. Direct healthcare costs and patients’ clinical characteristics were collected from medical records and long‐term care databases (n = 166). Indirect costs were estimated using a questionnaire survey which obtained information on job absenteeism and care time from the caregiver. A total of 112 patients responded to the survey. The median age was 82 years (interquartile range: 74–88). Total per‐person per month home‐care costs averaged USD 6,163 with direct costs (USD 2,547) and indirect costs (USD 3,596) accounted for 41.3% and 58.3% of the total costs, respectively. The largest components of direct costs were long‐term care costs (48%) and medical costs (47%). Multivariable adjusted model showed that those with heavy healthcare were more likely to incur higher total as well as direct and indirect home healthcare cost (p<.05 for each). Patients aged >75 years (p = .041) were less likely and those who used oxygen at home were more likely to incur direct home healthcare cost (p = .001) than their counterpart. Our study findings show that indirect cost is a major contributor to total home healthcare costs in Japan. Also for patients who need heavy healthcare, both direct and indirect costs are large burden.

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“…In Japan, the reasons why a family would consider themselves unable to provide care while having the patient reside at home include anxieties about what to do when the patients' status worsens and worries that they would not be able to provide sufficient care in the home setting. 22,23 In this study, approximately 40% of respondents felt that the decision was made to use the PCU without having sufficient time for related considerations. Persons forced to investigate PCU admission without knowledge of support services for at-home care and without sufficient time felt that they did not have enough information at the time when they made their decision.…”

Section: (11)mentioning

confidence: 84%

Are Bereaved Family Members Satisfied With Information Provision About Palliative Care Units in Japan?

Sanjo

Morita

Sato

et al. 2017

Am J Hosp Palliat Care

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This study clarified the evaluation of the information about palliative care units (PCUs) from the oncologists by the bereaved family members of Japanese patients with cancer at the time of their first referral. A multicenter questionnaire survey examining the amount, timing, and adequacy of information received about PCUs was conducted. Half of the respondents (N = 465, mean age = 60 years) were spouses. Findings showed that 55% of the respondents thought the amount of information was inadequate and 33% thought the timing of the information about PCU from the oncologist was inadequate. Greater perceived inadequacy of the amount of information was significantly associated with (1) obtaining information from other patients and/or family member who had no experience with PCUs and (2) not acquiring information about the availability of medical staff and medical treatments at PCUs. Greater perceived inadequacy of the timing of the information was significantly associated with acts by the oncologist and/or nurses, such as providing insufficient information or saying there is nothing more that can be done any longer; however, this was not significantly associated with the actual timing of the oncologists' information. Medical staff should understand what information families desire and provide enough detail for patients to imagine accurately what time spent in a PCU would be like. Moreover, practitioners should strive to improve methods of communication and engagement after the information provision, rather than prioritizing the timing of the information.

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Associations with the Japanese Population's Preferences for the Place of End-of-Life Care and Their Need for Receiving Health Care Services

Cited by 14 publications

References 32 publications

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

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

Direct and indirect costs of home healthcare in Japan: A cross‐sectional study

Are Bereaved Family Members Satisfied With Information Provision About Palliative Care Units in Japan?

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