Patient Preferences versus Family Physicians' Perceptions Regarding the Place of End-of-Life Care and Death: A Nationwide Study in Taiwan.
BACKGROUND
Enabling people to die in their preferred place is important for providing high-quality end-of-life care.


OBJECTIVE
The study objective was to explore patients' preferences regarding the place of end-of-life care and death and to compare these preferences with the perceptions of their family physicians.


METHODS
This cross-sectional study used stratified random sampling, surveying 400 registered patients and 200 of their family physicians nationwide, with a five-part, structured, self-report questionnaire.


RESULTS
Of the selected population, 310 patients (response rate 77.5%) and 169 physicians (response rate 84.5%) responded. Regarding the preferred place for end-of-life care, most of the patients would choose to receive care at home (60.6%) if home care services were available. Additionally, home was the most frequently preferred (66.5%) place of death. The family physicians' survey showed that a higher proportion of physicians selected home as the preferred place for end-of-life care and death (71.6% and 87.2%, respectively). The results of logistic regression analysis showed that patients younger than 50 years of age who believed in Chinese folk religion and who resided in a rural area were more likely to prefer to die at home.


CONCLUSIONS
The most commonly preferred place for end-of-life care and death is the patient's home. Establishing a community-based palliative care system should be encouraged to allow more individuals to die in their preferred locations. There were discrepancies in the preferred place of end-of-life care and death between the patients' preferences and their family physicians' perceptions. More effective physician-patient communication regarding end-of-life care is needed.
1 Department of Family Medicine, National Taiwan University Hospital Jin-Shan Branch , New Taipei City, Taiwan .
Chih-Yuan
CY
Shih
2 School of Nursing, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan .
Wen-Yu
WY
Hu
4 Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan .
Shao-Yi
SY
Cheng
4 Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan .
Chien-An
CA
Yao
3 Division of Gerontology Research, National Health Research Institutes , Zhunan, Miaoli County, Taiwan .|4 Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan .
Ching-Yu
CY
Chen
4 Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan .
Yen-Chun
YC
Lin
4 Department of Family Medicine, College of Medicine and Hospital, National Taiwan University , Taipei, Taiwan .
Tai-Yuan
TY
Chiu
D003430:Cross-Sectional Studies; D003643:Death; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D057240:Patient Preference; D010821:Physicians, Family / Q000523:psychology*; D057566:Self Report; D013624:Taiwan; D013727:Terminal Care