TY - JOUR
T1 - Clinical and Socio-Demographic Predictors of Home Hospice Patients Dying at Home
T2 - A Retrospective Analysis of Hospice Care Association's Database in Singapore
AU - Lee, Yee Song
AU - Akhileswaran, Ramaswamy
AU - Ong, Eng Hock Marcus
AU - Wah, Win
AU - Hui, David
AU - Ng, Sheryl Hui Xian
AU - Koh, Gerald
N1 - Publisher Copyright:
© 2017 American Academy of Hospice and Palliative Medicine
PY - 2017/6
Y1 - 2017/6
N2 - Context Hospice care can be delivered in different settings, but many patients choose to receive it at home because of familiar surroundings. Despite their preferences, not every home hospice patient manages to die at home. Objective To examine the independent factors associated with home hospice patient dying at home. Methods Retrospective analysis of Hospice Care Association's database. Hospice Care Association is the largest home hospice provider in Singapore. The study included all patients who were admitted into home hospice service from January 1, 2004 to December 31, 2013. Cox proportional hazards modeling with time as constant was used to study the relationship between independent variables and home death. Results A total of 19,721 patients were included in the study. Females (adjusted risk ratio [ARR] 1.09, 95% CI 1.04–1.15), older patients (ARR 1.01, 95% CI 1.00–1.01), shorter duration of home hospice stay (ARR 0.88, 95% CI 0.82–0.94), fewer episodes of hospitalization (ARR 0.81, 95% CI 0.75–0.86), living with caregivers (ARR 1.54, 95% CI 1.05–2.26), doctor (ARR 1.05, 95% CI 1.01–1.08) and nurse (ARR 1.06, 95% CI 1.04–1.08) visits were positive predictors of dying-at-home. Diagnosis of cancer (ARR 0.93, 95% CI 0.86–1.00) was a negative predictor of dying-at-home. Conclusion Female, older age, living with a caregiver, non-cancer diagnosis, more doctor and nurse visits, shorter duration of home hospice stays, and fewer episodes of acute hospitalizations are predictive of dying-at-home for home hospice patients.
AB - Context Hospice care can be delivered in different settings, but many patients choose to receive it at home because of familiar surroundings. Despite their preferences, not every home hospice patient manages to die at home. Objective To examine the independent factors associated with home hospice patient dying at home. Methods Retrospective analysis of Hospice Care Association's database. Hospice Care Association is the largest home hospice provider in Singapore. The study included all patients who were admitted into home hospice service from January 1, 2004 to December 31, 2013. Cox proportional hazards modeling with time as constant was used to study the relationship between independent variables and home death. Results A total of 19,721 patients were included in the study. Females (adjusted risk ratio [ARR] 1.09, 95% CI 1.04–1.15), older patients (ARR 1.01, 95% CI 1.00–1.01), shorter duration of home hospice stay (ARR 0.88, 95% CI 0.82–0.94), fewer episodes of hospitalization (ARR 0.81, 95% CI 0.75–0.86), living with caregivers (ARR 1.54, 95% CI 1.05–2.26), doctor (ARR 1.05, 95% CI 1.01–1.08) and nurse (ARR 1.06, 95% CI 1.04–1.08) visits were positive predictors of dying-at-home. Diagnosis of cancer (ARR 0.93, 95% CI 0.86–1.00) was a negative predictor of dying-at-home. Conclusion Female, older age, living with a caregiver, non-cancer diagnosis, more doctor and nurse visits, shorter duration of home hospice stays, and fewer episodes of acute hospitalizations are predictive of dying-at-home for home hospice patients.
KW - Palliative care
KW - cancer
KW - home care
KW - home hospice
KW - hospice care
KW - neoplasm
KW - place of death
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U2 - 10.1016/j.jpainsymman.2017.01.008
DO - 10.1016/j.jpainsymman.2017.01.008
M3 - Article
C2 - 28196785
AN - SCOPUS:85017348908
SN - 0885-3924
VL - 53
SP - 1035
EP - 1041
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 6
ER -