Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Clin Oncol. 2012 Aug 1;30(22):2783-7. doi: 10.1200/JCO.2011.41.5711. Epub 2012 Jun 25.

Which hospice patients with cancer are able to die in the setting of their choice? Results of a retrospective cohort study.

Author information

  • 1University of Pennsylvania Perelman School of Medicine, Philadelphia , PA 19104, USA.

Abstract

PURPOSE:

To determine which hospice patients with cancer prefer to die at home and to define factors associated with an increased likelihood of dying at home.

METHODS:

An electronic health record-based retrospective cohort study was conducted in three hospice programs in Florida, Pennsylvania, and Wisconsin. Main measures included preferred versus actual site of death.

RESULTS:

Of 7,391 patients, preferences regarding place of death were determined at admission for 5,837 (79%). After adjusting for other characteristics, patients who preferred to die at home were more likely to die at home (adjusted proportions, 56.5% v 37.0%; odds ratio [OR], 2.21; 95% CI, 1.77 to 2.76). Among those patients (n = 3,152) who preferred to die at home, in a multivariable logistic regression model, patients were more likely to die at home if they had at least one visit per day in the first 4 days of hospice care (adjusted proportions, 61% v 54%; OR, 1.23; 95% CI, 1.07 to 1.41), if they were married (63% v 54%; OR, 1.35; 95% CI, 1.10 to 1.44), and if they had an advance directive (65% v 50%; OR, 2.11; 95% CI, 1.54 to 2.65). Patients with moderate or severe pain were less likely to die at home (OR, 0.56; 95% CI, 0.45 to 0.64), as were patients with better functional status (higher Palliative Performance Scale score: < 40, 64.8%; 40 to 70, 50.2%; OR, 0.79; 95% CI, 0.67 to 0.93; > 70, 40.5%; OR, 0.53; 95% CI, 0.35 to 0.82).

CONCLUSION:

Increased hospice visit frequency may increase the likelihood of patients being able to die in the setting of their choice.

Comment in

PMID:
22734023
[PubMed - indexed for MEDLINE]
PMCID:
PMC3402887
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk