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Effectiveness of home hospice care: a nationwide prospective observational study

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Data availability

The data used in this study can be obtained in anonymized form by contacting the Central Hospice Center (ncchospice@ncc.re.kr).

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Funding

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).

Author information

Author notes

  1. Eunmi Ahn and In Gyu Song contributed equally to this work.

Authors and Affiliations

  1. Division of Health Services Development for Persons with Disabilities, Ministry of Health and Welfare National Rehabilitation Center, 58 Samgaksan-ro, GangBuk-gu, Seoul, 01022, South Korea

    Eunmi Ahn

  2. National Hospice Center, National Cancer Center, 323 Ilsan-ro, Ilsnadong-gu, Goyang-si, Gyeonggi-do, South Korea

    In Gyu Song, Jin Young Choi, Hyun Jung Jho, Ilyeon Park, Suah Sung, Seohyun Shin, So Jung Park, Eun Jung Nam, Sung Hoon Jeong & Yoon Jung Chang

Authors
  1. Eunmi Ahn
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  2. In Gyu Song
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  3. Jin Young Choi
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  4. Hyun Jung Jho
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  5. Ilyeon Park
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  7. Seohyun Shin
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  8. So Jung Park
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  9. Eun Jung Nam
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  11. Yoon Jung Chang
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Corresponding author

Correspondence to Yoon Jung Chang.

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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

Informed consent was obtained from all individual participants included in the study.

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Ahn, E., Song, I.G., Choi, J.Y. et al. Effectiveness of home hospice care: a nationwide prospective observational study . Support Care Cancer 28, 2713–2719 (2020). https://doi.org/10.1007/s00520-019-05091-7

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