Factors associated with preference for dying at home among terminally ill patients with cancer

Schou-Andersen, Marianne; Ullersted, Maria P.; Jensen, Anders Bonde; Neergaard, Mette Asbjoern

doi:10.1111/scs.12265

Cited by 23 publications

(30 citation statements)

References 17 publications

(31 reference statements)

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“…These findings are consistent with literature that has identified socioeconomic determinants that increase rates of preference for home death, including identifying as non-Hispanic white race [ 42 ], greater education level, greater income levels, greater awareness of advanced directives [ 43 ], and more supportive living arrangements [ 44 ]. These findings can be contrasted with earlier studies, which found that immigrant or direct descendants express a higher preference for home death [ 45 ] and a higher likelihood of dying at home [ 24 ]. Building on our findings, further research is needed to more completely characterize how socioeconomic factors influence preference for home death.…”

Section: Discussioncontrasting

confidence: 99%

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

2018

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BackgroundHome is a preferred place of death for many people; however, access to a home death may not be equitable. The impact of socioeconomic status on one’s ability to die at home has been documented, yet there remains little literature exploring mechanisms that contribute to this disparity. By exploring the experiences and insights of physicians who provide end-of-life care in the home, this study aims to identify the factors perceived to influence patients’ likelihood of home death and describe the mechanisms by which they interact with socioeconomic status.MethodsIn this exploratory qualitative study, we conducted interviews with 9 physicians who provide home-based care at a specialized palliative care centre. Participants were asked about their experiences caring for patients at the end of life, focusing on factors believed to impact likelihood of home death with an emphasis on socioeconomic status, and opportunities for intervention. We relied on participants’ perceptions of SES, rather than objective measures. We used an inductive content analysis to identify and describe factors that physicians perceive to influence a patient’s likelihood of dying at home.ResultsFactors identified by physicians were organized into three categories: patient characteristics, physical environment and support network. Patient preference for home death was seen as a necessary factor. If this was established, participants suggested that having a strong support network to supplement professional care was critical to achieving home death. Finally, safe and sustainable housing were also felt to improve likelihood of home death. Higher SES was perceived to increase the likelihood of a desired home death by affording access to more resources within each of the categories. This included better health and health care understanding, a higher capacity for advocacy, a more stable home environment, and more caregiver support.ConclusionsSES was not perceived to be an isolated factor impacting likelihood of home death, but rather a means to address shortfalls in the three identified categories. Identifying the factors that influence ability is the first step in ensuring home death is accessible to all patients who desire it, regardless of socioeconomic status.

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Section: Discussioncontrasting

confidence: 99%

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

2018

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“…Perhaps autonomy represents a greater value for those with higher education and the house is perceived as a place of greater empowerment 31 . However, there are few studies that investigates the associations between preference for home death and level of education 32 . Previous research in Ibiza 33 and China 34 showed that low educational attainment is associated with a greater preference for death at home and those with higher attainment prefer to die in institutions 32 .…”

Section: Discussionmentioning

confidence: 99%

Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

Jorge

Calanzani

Freitas

et al. 2019

Ciênc. saúde coletiva

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We examined people’s preferences for place of death and identified factors associated with a home death preference. We asked a representative sample (N = 400) of older people (≥ 60 years) residents in the city of Belo Horizonte, about their preferences for place of death in a situation of serious illness with less than a year to live. Data were analyzed using binomial regression to identify associated factors. 52.2% indicate home as the preferred place of death. Five variables were associated with preference for death at home: those living with 1 child (odds ratio (OR)0.41; 95% confidence interval (CI):0.18-0.92; ref: without children); being in education for up to 4 years (OR0.42; 95% CI:0.20-0.89; ref: higher education); finding it difficult to live with the present income (OR3.18; 95% CI:1.53-6.62; ref: living comfortably); self-assessed fair overall health (OR2.07; 95% CI:1.06-4.03; ref: very good health) and selecting “choosing who makes decisions about your care” as the care priority that would matter to them the most (OR2.43; 95%CI:1.34-4.40; ref: dying in the place you want). Most respondents chose home as preferred place of death. However, most residents of Belo Horizonte die in hospitals, suggesting that preferences are not being considered.

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“…A death at home has been considered as a significant outcome and a "good death" in a large body of research in end of life care [1] [2] [3] [4] [5] due to better quality of care [2] [6] and autonomy [3] [5] [6]. The main body of literature shows that people prefer to die at home [5] [7] [8] [9] irrespective of their health conditions and living arrangements prior to death [7] [8].…”

Section: Introductionmentioning

confidence: 99%

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

Rhee¹,

Tae²,

Lee³

et al. 2019

JBM

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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.

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Factors associated with preference for dying at home among terminally ill patients with cancer

Cited by 23 publications

References 17 publications

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

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

Preference for death at home and associated factors among older people in the city of Belo Horizonte, Brazil

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

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