Home death is associated with frequency of physician home medical care visits: a questionnaire survey on communications in home medical care settings.
OBJECTIVE
To investigate the factors related to communications in home medical care settings, and the association between such factors and a patient's place of death.


METHODS
A questionnaire survey of 295 families of patients who had previously received home medical care was carried out in June and July 2011. The response rate was 83.8% (n = 227). Following the exclusion of families where the patient was still alive, or where the place of death was unknown, 143 questionnaires were available for analysis. Logistic regression was used to identify significant associations between possible factors related to communication and occurrence of home death.


RESULTS
Home death was observed in 66.4% (n = 95) of the families analyzed. Home death was significantly associated with the frequency of doctor home-visits per week (OR 2.835, 95% CI 1.436-5.597, P = 0.003). There was no statistically significant association between home death and any of the other variables included: malignant tumors as primary disease, independence in daily activity, duration of home medical care, duration of doctor's visits, experience of doctor-patient communication without family, doctor-family communication without the patient or explanation from the doctor on the phone, existence of home-visit nursing services, existence of family's anxieties and/or questions, age of primary caregiver(s) and sex of primary caregiver(s).


CONCLUSIONS
The frequency of doctor home-visits was the only factor identified that was positively associated with the occurrence of home death in home medical care settings.
Department of General Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa; Department of General Medicine, National Hospital Organization, Higashisaitama Hospital, Hasuda, Saitama.
Takuma
T
Kimura
Teruhiko
T
Imanaga
Makoto
M
Matsuzaki
Tohru
T
Akahoshi
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003142:Communication; D005190:Family / Q000523:psychology; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D017052:Hospital Mortality; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
communication; doctor; family; home death; home medical care