Effectiveness of home hospice care: a nationwide prospective observational study
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Many assert the need for home hospice care. However, limited research has shown its effectiveness. The authors of this study thus evaluated the effectiveness of a home hospice care pilot project regarding (1) early enrollment in hospice care, (2) efficient use of inpatient hospice resources, and (3) enabling terminally ill patients to stay at their preferred place of care.
The authors conducted a nationwide prospective observational study. Patients were divided into home hospice care users (ever-users, n = 902) and inpatient-only hospice care users (never-users, n = 8210). Information about hospice service utilization was collected from a web-based registry system. Patients were registered if they started to receive the hospice service after providing written informed consent during the pilot project from March 2016–July 2017.
Most ever-users preferred to stay at home (84.0%), while never-users preferred hospital admission (66.9%). Most ever-users were enrolled in hospice by home care (78.9%) and used both home and inpatient care (72.4%). The overall duration of hospice care was significantly longer among ever-users than never-users (median 39 vs. 15 days, respectively; mean ± SD 59.6 ± 62.8 vs. 24.8 ± 32.1, respectively; p < .001). Participation in the pilot program improved bed utilization (p = .025) and turnover rate (p < .001) of inpatient hospice service.
Home hospice care enabled early enrollment in hospice services and provided a valid option to patients who wished to stay at home. Policy efforts to facilitate home hospice care are needed.
KeywordsHospice care Home care Palliative care Cancer Utilization Effectiveness
This work was supported by a grant from the National R&D Programme for Cancer Control, Ministry of Health and Welfare, Republic of Korea (nos. 1431620-1, 1810140-1 and 1911000-1).
Compliance with ethical standards
Conflict of interest
The authors declare that there are no conflicts of interest.
Research involving human participants and/or animals
All procedures performed were in accordance with the ethical standards of the Institutional Review Board of the National Cancer Centre (review no. NCCNCS09234) and with the 1964 Helsinki declaration and its later amendments. Information about patients was collected based on the Cancer Control Act in Korea. It was a mandatory registration project to promote hospice care in Korea.
Informed consent was obtained from all individual participants included in the study.
- 1.World Health Organization (2014) Global atlas of palliative care at the end of life. https://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf. Accessed 10 March 2017.
- 6.Chang YJ, Choi JY, Ahn EM, Jho HJ, Park EJ (2015) Driving hospice home care model ensuring the continuity of care. National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of KoreaGoogle Scholar
- 9.Korean Statistical Information System. Annual report on the causes of death statistics. http://kosis.nso.go.kr. Accessed 04 May 2017.
- 10.Gomes B, Calanzani N, Curiale V, McCrone P, Higginson IJ (2013) Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database Syst Rev 6:CD007760Google Scholar
- 19.Sharpe KH, Cezard G, Bansal N, Bhopal RS, Brewster DH (2015) Policy for home or hospice as the preferred place of death from cancer: Scottish health and ethnicity linkage study population cohort shows challenges across all ethnic groups in Scotland. BMJ Support Palliat Care 5:443–451CrossRefGoogle Scholar
- 20.Ninosaka Y (2015) Death, dignity, and the significance of home hospice care. Jpn Med Assoc J 58:44–47Google Scholar