TY - JOUR
T1 - Which hospice patients with cancer are able to die in the setting of their choice? Results of a retrospective cohort study
AU - Jeurkar, Neha
AU - Farrington, Sue
AU - Craig, Teresa R.
AU - Slattery, Julie
AU - Harrold, Joan K.
AU - Oldanie, Betty
AU - Teno, Joan M.
AU - Casarett, David J.
PY - 2012/8/1
Y1 - 2012/8/1
N2 - 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.
AB - 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.
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U2 - 10.1200/JCO.2011.41.5711
DO - 10.1200/JCO.2011.41.5711
M3 - Article
C2 - 22734023
AN - SCOPUS:84864562621
SN - 0732-183X
VL - 30
SP - 2783
EP - 2787
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 22
ER -