Propensity for Home Death Among Taiwanese Cancer Decedents in…台湾癌症患者的家庭死亡倾向.pdfVIP

566 Journal of Pain and Symptom Management Vol. 40 No. 4 October 2010 Original Article Propensity for Home Death Among Taiwanese Cancer Decedents in 2001e2006, Determined by Services Received at End of Life Siew Tzuh Tang, DNSc, Ean-Wen Huang, PhD, Tsang-Wu Liu, MD, Kun-Ming Rau, MD, Yen-Ni Hung, PhD, and Shiao-Chi Wu, PhD Graduate School of Nursing (S.T.T.) and College of Medicine (K.-M.R.), Chang Gung University; Tao-Yuan; Nursing Department (S.T.T.), Chang Gung Memorial Hospital, Kaohsiung; Department of Information Management (E.-W.H.), National Taipei College of Nursing, Taipei; National Institute of Cancer Research (T.-W.L.), National Health Research Institutes, Taipei; Division of Hematology- Oncology (K.-M.R.), Chang Gung Medical Foundation, Kaohsiung; and Institute of Health and Welfare Policy (Y.-N.H., S.-C.W.), National Yang-Ming University, Taipei, Taiwan, Republic of China Abstract Context. The discrepancy between patients’ preferred and actual place of death highlights the dilemma inherent in achieving their preferences for home death. Research on determinants of home death has been limited largely by focusing on individual-level factors and somewhat on health care resources at the primary hospital and regional levels. Objectives. To investigate factors associated with home death, specifically, services received by cancer patients at the end of life (EOL). Methods. This was a retrospective cohort study using administrative data from 201,201 Taiwanese cancer decedents in the period 2001e2006. Results. Rates of home death decreased significantly over time (from 35.67% to 32.39%). Dying at home was associated with patient demographics (gender, age, and marital status) and disease characteristics (cancer type, metastatic status, postdiagnosis survival time, and comorbidity level). Taiwanese cancer patients were less likely to die at home if they received care from a me