Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Canadian Center for Health Economics, Toronto, ON, Canada.
Health Soc Care Community. 2020 Sep;28(5):1807-1816. doi: 10.1111/hsc.13007. Epub 2020 May 4.
Understanding the temporal trends in the place of death among patients in receipt of home-based palliative care can help direct health policies and planning of health resources. This paper aims to assess the temporal trends in place of death and its determinants over the past decade for patients receiving home-based palliative care. This paper also examines the impact of early referral to home-based palliative care services on patient's place of death. Survey data collected in a home-based end-of-life care program in Toronto, Canada from 2005 to 2015 were analysed using a multivariate logistic model. The results suggest that the place of death for patients in receipt of home-based palliative care has changed over time, with more patients dying at home over 2006-2015 when compared to 2005. Also, early referral to home-based palliative care services may not increase a patient's likelihood of home death. Understanding the temporal shifts of place of death and the associated factors is essential for effective improvements in home-based palliative care programs and the development of end-of-life care policies.
了解接受居家姑息治疗患者的死亡地点的时间趋势有助于指导卫生政策和卫生资源规划。本文旨在评估过去十年中接受居家姑息治疗患者的死亡地点及其决定因素的时间趋势。本文还探讨了早期转介至居家姑息治疗服务对患者死亡地点的影响。本研究使用多变量逻辑模型对 2005 年至 2015 年期间在加拿大多伦多开展的居家临终关怀项目中收集的调查数据进行了分析。结果表明，接受居家姑息治疗患者的死亡地点随时间发生了变化，与 2005 年相比，2006-2015 年有更多的患者在家中死亡。此外，早期转介至居家姑息治疗服务可能不会增加患者在家中死亡的可能性。了解死亡地点的时间变化和相关因素对于改善居家姑息治疗计划和制定临终关怀政策至关重要。
