Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database

BACKGROUND: Over half of the Japanese population hope to spend their last days at home; however, 73.0% die in hospitals. The proportion of deaths due to cancer in hospitals is even higher, at 82.4%, and is also high globally. Therefore, there is an urgent need to establish conditions that fulfill th...

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Autores principales: Tarasawa, Kunio, Fujimori, Kenji, Ogata, Tomoaki, Chiba, Hiroki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Geriatrics Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326408/
https://www.ncbi.nlm.nih.gov/pubmed/37305898
http://dx.doi.org/10.4235/agmr.23.0048
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author Tarasawa, Kunio
Fujimori, Kenji
Ogata, Tomoaki
Chiba, Hiroki
author_facet Tarasawa, Kunio
Fujimori, Kenji
Ogata, Tomoaki
Chiba, Hiroki
author_sort Tarasawa, Kunio
collection PubMed
description BACKGROUND: Over half of the Japanese population hope to spend their last days at home; however, 73.0% die in hospitals. The proportion of deaths due to cancer in hospitals is even higher, at 82.4%, and is also high globally. Therefore, there is an urgent need to establish conditions that fulfill the hopes of patients, especially those with cancer, who hope to spend their last days at home. This study aimed to clarify medical resources and activities that are related to proportion of death at home among cancer patients. METHODS: We used data from the Japanese National Database and public data. Japan's Ministry of Health, Labour, and Welfare provides national data on medical services to applicants for research purposes. Using the data, we calculated the proportion of deaths at home in each prefecture. We also collected information on medical resources and activities from public data and conducted multiple regression analyses to investigate factors associated with the proportion of death at home. RESULTS: In total, 51,874 eligible patients were identified. The maximum and minimum proportions of death at home based on prefectures differed by approximately three-fold (14.8%–41.6%). We also identified scheduled home-visit medical care (coefficient=0.580) and acute and long-term care beds (coefficient=-0.317 and -0.245) as factors that increased and decreased the proportion of death at home, respectively. CONCLUSION: To fulfill the hopes of cancer patients to spend their last days at home, we recommend that the government develop policies to increase home visits by physicians and optimize hospital acute and long-term care beds.
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spelling pubmed-103264082023-07-08 Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database Tarasawa, Kunio Fujimori, Kenji Ogata, Tomoaki Chiba, Hiroki Ann Geriatr Med Res Original Article BACKGROUND: Over half of the Japanese population hope to spend their last days at home; however, 73.0% die in hospitals. The proportion of deaths due to cancer in hospitals is even higher, at 82.4%, and is also high globally. Therefore, there is an urgent need to establish conditions that fulfill the hopes of patients, especially those with cancer, who hope to spend their last days at home. This study aimed to clarify medical resources and activities that are related to proportion of death at home among cancer patients. METHODS: We used data from the Japanese National Database and public data. Japan's Ministry of Health, Labour, and Welfare provides national data on medical services to applicants for research purposes. Using the data, we calculated the proportion of deaths at home in each prefecture. We also collected information on medical resources and activities from public data and conducted multiple regression analyses to investigate factors associated with the proportion of death at home. RESULTS: In total, 51,874 eligible patients were identified. The maximum and minimum proportions of death at home based on prefectures differed by approximately three-fold (14.8%–41.6%). We also identified scheduled home-visit medical care (coefficient=0.580) and acute and long-term care beds (coefficient=-0.317 and -0.245) as factors that increased and decreased the proportion of death at home, respectively. CONCLUSION: To fulfill the hopes of cancer patients to spend their last days at home, we recommend that the government develop policies to increase home visits by physicians and optimize hospital acute and long-term care beds. Korean Geriatrics Society 2023-06 2023-06-09 /pmc/articles/PMC10326408/ /pubmed/37305898 http://dx.doi.org/10.4235/agmr.23.0048 Text en Copyright © 2023 Korean Geriatrics Society https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Tarasawa, Kunio
Fujimori, Kenji
Ogata, Tomoaki
Chiba, Hiroki
Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database
title Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database
title_full Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database
title_fullStr Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database
title_full_unstemmed Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database
title_short Associations of Death at Home with Medical Resources and Medical Activities in Cancer Patients: A Nationwide Study Using Japanese National Database
title_sort associations of death at home with medical resources and medical activities in cancer patients: a nationwide study using japanese national database
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326408/
https://www.ncbi.nlm.nih.gov/pubmed/37305898
http://dx.doi.org/10.4235/agmr.23.0048
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