Determinants of place of death for recipients of home-based palliative care.
BACKGROUND
Health system restructuring combined with the preferences of many terminally ill care recipients and their caregivers has led to an increase in home-based palliative care, yet many care recipients die within institutional settings such as hospitals. This study sought to determine the place of death and its predictors among palliative care patients with cancer.


METHODS
Study participants were recruited from the Temmy Latner Centre for Palliative Care, a regional palliative care program based in Toronto, Canada. A total of 137 patients and their family caregivers participated in the study; application of various exclusion criteria restricted analysis to a sub-sample of 110. Bivariate (chi-square) and multivariate (logistic regression) analyses were conducted.


RESULTS
66 percent of participants died at home. Chi-square analysis indicated that women were more likely to die at home than men; multivariate analysis indicated that women and those living with others were significantly more likely to die at home than men or those who lived alone.


CONCLUSIONS
Place of death is influenced by the socio-demographic characteristics of patients, the characteristics of their caregivers, and health service factors. Palliative care programs need to tailor services to men and those living alone in order to reduce institutional deaths.
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Lisa
L
Masucci
Denise N
DN
Guerriere
Richard
R
Cheng
Peter C
PC
Coyte
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005190:Family; D005260:Female; D033062:Friends; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D010166:Palliative Care / Q000458:organization & administration*; D012111:Residence Characteristics; D012737:Sex Factors; D012944:Social Support; D012959:Socioeconomic Factors