• Hiroyuki Nishie, Satoshi Mizobuchi, Etsuji Suzuki, Kenji Sato, Yuichiro Toda, Junji Matsuoka, and Hiroshi Morimatsu.
• Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama 700-8558, Japan.nishie-h@cc.okayama-u.ac.jp.
• Acta Med Okayama. 2014 Dec 1;68(6):339-48.

AbstractThe main purpose of this study was to determine the relationships between Japanese individuals' interest in living wills and their preferred end-of-life care and death locations. Questionnaires were mailed to 1,000 individuals aged >50 to measure these 2 factors. We examined the associations between the respondents' characteristics and their preferred care and death locations by using multinomial logistic regression models. The response rate was 74%. Home was the most frequently preferred place for end-of-life care (64%), and a palliative care unit (PCU) was the most commonly preferred place to die (51%). Living will interest was associated with a preference for care (odds ratio [OR] 4.74, 95% confidence interval [CI] 1.95-12.1) and death (OR 2.75, 95% CI 1.70-4.47) in a PCU rather than a hospital, but it was not associated with the choice between receiving care or dying at home instead of a hospital. We must consider why Japanese people think home death is impracticable. The Japanese palliative care system should be expanded to meet patients' end-of-life needs, and this includes not only facilitating home care but also increasing access to PCU care.

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