title: The nursing home versus the hospital as the place of dying for nursing home residents in Japan.
abstract: OBJECTIVE
  To determine the characteristics of nursing home residents that are associated with dying in a nursing home versus a hospital in Japan.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  A nonprofit nursing home with 110 beds in Tokyo, Japan.
  
  
  METHODS
  Eighty-six nursing home residents who died in the nursing home (n=43) or in a hospital (n=43) between 1 April 1999 and 30 September 2004.
  
  
  METHODS
  Nursing home records were reviewed to gain information regarding the following domains: demography, the family decision-maker, health status, resident and family preference for nursing home end-of-life care, and presence of a full-time physician.
  
  
  RESULTS
  The variables older age [adjusted odds ratio (adjusted OR)=1.08, 95% confidence interval (95% CI)=1.01-1.17], the family decision-maker's preference for nursing home end-of-life care (adjusted OR=3.95, 95% CI=1.21-12.84), and presence of a full-time physician (adjusted OR=3.74, 95% CI=1.03-13.63) were associated with dying in the nursing home.
  
  
  CONCLUSIONS
  Older age, the family's preference for nursing home end-of-life care, and the presence of a full-time physician were significantly related to dying in the nursing home versus in a hospital.
authors.affiliation: Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, 3311-1 Shimotuske-City, Tochigi 329-0498, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Takezako
authors.forename: Nanako
authors.initials: N
authors.lastname: Tamiya
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajii
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006761:Hospitals; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D012111:Residence Characteristics; D012189:Retrospective Studies; D019452:Terminally Ill; D014041:Tokyo