• Ming-Chung Ko, Sheng-Jean Huang, Chu-Chieh Chen, Yu-Ping Chang, Hsin-Yi Lien, Jia-Yi Lin, Lin-Chung Woung, and Shang-Yih Chan.
• aDepartment of Urology, Taipei City Hospital, Taipei City bDepartment of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City cSchool of Medicine, Fu-Jen Catholic University, New Taipei City dSuperintendent Office, Taipei City Hospital, Taipei City eDepartment of Surgery, National Taiwan University, Taipei City fCenter of Quality Management, Taipei City Hospital, Taipei City gCross-Strait Medical and Management Communication Center, Taipei City Hospital, Taipei City hAdministrative Center, Ministry of Health and Welfare Taipei Hospital, New Taipei City iDepartment of Cardiology, Taipei City Hospital, Taipei City, Taiwan.
• Medicine (Baltimore). 2017 Oct 1; 96 (41): e8210.

AbstractAwareness of factors affecting the place of death could improve communication between healthcare providers and patients and their families regarding patient preferences and the feasibility of dying in the preferred place.This study aimed to evaluate factors predicting home death among home palliative care recipients.This is a population-based study using a national representative sample retrieved from the National Health Insurance Research Database. Subjects receiving home palliative care, from 2010 to 2012, were analyzed to evaluate the association between a home death and various characteristics related to illness, individual, and health care utilization. A multiple-logistic regression model was used to assess the independent effect of various characteristics on the likelihood of a home death.The overall rate of a home death for home palliative care recipients was 43.6%. Age; gender; urbanization of the area where the patients lived; illness; the total number of home visits by all health care professionals; the number of home visits by nurses; utilization of nasogastric tube, endotracheal tube, or indwelling urinary catheter; the number of emergency department visits; and admission to intensive care unit in previous 1 year were not significantly associated with the risk of a home death. Physician home visits increased the likelihood of a home death. Compared with subjects without physician home visits (31.4%) those with 1 physician home visit (53.0%, adjusted odds ratio [AOR]: 3.23, 95% confidence interval [CI]: 1.93-5.42) and those with ≥2 physician home visits (43.9%, AOR: 2.23, 95% CI: 1.06-4.70) had higher likelihood of a home death. Compared with subjects with hospitalization 0 to 6 times in previous 1 year, those with hospitalization ≥7 times in previous 1 year (AOR: 0.57, 95% CI: 0.34-0.95) had lower likelihood of a home death.Among home palliative care recipients, physician home visits increased the likelihood of a home death. Hospitalizations ≥7 times in previous 1 year decreased the likelihood of a home death.

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