title: Predictors of Place of Death of Individuals in a Home-Based Primary and Palliative Care Program.
abstract: To investigate factors associated with place of death of individuals in the Mount Sinai Visiting Doctors Program (MSVD).
  
  
  
  A retrospective chart review was performed of all MSVD participants who died in 2012 to assess predictors of place of death in the last month of life.
  
  
  
  MSVD, a home-based primary and palliative care program in New York.
  
  
  
  MSVD participants who were discharged from the program because of death between January 2012 and December 2012 and died at home, in inpatient hospice, or in the hospital (N = 183).
  
  
  
  Electronic medical records were reviewed to collect information on demographic characteristics, physician visits, and end-of-life conversations.
  
  
  
  Of 183 participants, 103 (56%) died at home, approximately twice the national average; 28 (15%) died in inpatient hospice; and 52 (28%) died in the hospital. Bivariate analyses showed that participants who were white, aged 90 and older, non-Medicaid, or had a recorded preference for place of death were more likely to die outside the hospital. Diagnoses and living situation were not significantly associated with place of death. Multivariate logistic regression analysis showed no statistical association between place of death and home visits in the last month of life (odds ratio = 1.21, 95% confidence interval = 0.52-2.77).
  
  
  
  Home-based primary and palliative care results in a high likelihood of nonhospital death, although certain demographic characteristics are strong predictors of death in the hospital. For MSVD participants, home visits in the last month of life were not associated with death outside the hospital.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York City, New York.
authors.forename: Phoebe G
authors.initials: PG
authors.lastname: Prioleau
authors.affiliation: Department of Geriatrics and Palliative Medicine, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
authors.forename: Tacara N
authors.initials: TN
authors.lastname: Soones
authors.affiliation: Department of Geriatrics and Palliative Medicine, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.|Division of General Internal Medicine, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
authors.forename: Katherine
authors.initials: K
authors.lastname: Ornstein
authors.affiliation: Department of Geriatrics and Palliative Medicine, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
authors.forename: Meng
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Division of Hematology and Medical Oncology, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
authors.forename: Cardinale B
authors.initials: CB
authors.lastname: Smith
authors.affiliation: Division of General Internal Medicine, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York.
authors.forename: Ania
authors.initials: A
authors.lastname: Wajnberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003643:Death; D005260:Female; D006699:Home Care Services; D017051:Hospice Care; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009519:New York City; D010166:Palliative Care; D011320:Primary Health Care; D012189:Retrospective Studies
keywords: end-of-life care; home-based primary and palliative care; place of death