title: A Study of the Association Between Multidisciplinary Home Care and Home Death Among Thai Palliative Care Patients.
abstract: OBJECTIVE
  Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death.
  
  
  METHODS
  A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014. All of the patients who were referred to multidisciplinary palliative care teams were included. The data set comprised of patient's profile, disease status, functional status, patient's symptoms, preferred place of death, frequency of home visits, types of team interventions, and patient's actual place of death. Multiple logistic regression was applied in order to determine the association between the variables and the probability of dying at home.
  
  
  RESULTS
  A total of 142 patients were included into the study. At the end of the study, 50 (35.2%) patients died at home and 92 (64.8%) patients died in the hospital. The multivariate logistic regression analysis demonstrated a strong association between multidisciplinary home care and home death (odds ratio 6.57, 95% confidence interval [CI] 2.48-17.38).
  
  
  CONCLUSIONS
  Palliative home care was a significant factor enabling patients who want to die at home. We encourage health policy makers to promote the development of community-based palliative care programs in Thailand.
authors.affiliation: 1 Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kittiphon
authors.initials: K
authors.lastname: Nagaviroj
authors.affiliation: 1 Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Thunyarat
authors.initials: T
authors.lastname: Anothaisintawee
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006699:Home Care Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000458:organization & administration; D057240:Patient Preference; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013727:Terminal Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D013785:Thailand; D055815:Young Adult
keywords: Thailand; home care; home death; home visit; multidisciplinary team; palliative