title: [Reason why home hospice is not widespread in Japan].
abstract: A home hospice care program was begun at Fukushima Rousai Hospital in 1987. Nowadays, fifty percent or more of patients who die of cancer use this program, and patients who die in their own homes have reached about 40 percent. Based on our experience, we analyzed the factors in why home hospice care is not widespread in Japan, and pointed out some factors as follows. The main factors are insufficient disclosure of information regarding diagnosis and disease progression, poor palliative care, and incompleteness of the visit medical treatment system. Other factors are doctors' zeal for cure, patients' and/or families' excessive expectation of recovery, insufficient numbers of doctors and nurses with knowledge and skills concerning the home hospice care, doctors' and/or families' conviction that death in the hospital is natural, lack of social systems that support the family, limitations in the use of medicine at insurance drugstores, and the fact that insurance cannot be adjusted for medical treatment in the patients' home.
authors.affiliation: Dept. of Surgery, Fukushima Rousai Hospital.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ashino
mesh_terms: D003365:Costs and Cost Analysis; D019538:Health Care Surveys; D018575:Home Care Services, Hospital-Based / Q000191:economics; D017051:Hospice Care / Q000191:economics / Q000523:psychology; D006801:Humans; D010348:Patient Care Team; D011787:Quality of Health Care; D012051:Reimbursement Mechanisms