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Factors Associated with Place of Death in Korean Patients with Terminal Cancer

  • Hyun, Min Kyung (National Evidence-based Healthcare Collaborating Agency) ;
  • Jung, Kyung Hae (Department of Oncology, Asian Medical Center) ;
  • Yun, Young Ho (Seoul National University Hospital and College of Medicine) ;
  • Kim, Young Ae (Research Institute and Hospital, National Cancer Center) ;
  • Lee, Woo Jin (Research Institute and Hospital, National Cancer Center) ;
  • Do, Young Rok (Division of Hematooncology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lee, Keun Seok (Research Institute and Hospital, National Cancer Center) ;
  • Heo, Dae Seog (Cancer Research Institute, Department of Internal Medicine, Seoul National University Hospital) ;
  • Choi, Jong Soo (Department of Oncology, Gangneung Asian Hospital, University of Ulsan College of Medicine) ;
  • Kim, Sam Yong (Division of Hematooncology, Department of Internal Medicine, Chungnam University School of Medicine) ;
  • Kim, Heung Tae (Research Institute and Hospital, National Cancer Center) ;
  • Hong, Seok-Won (National Evidence-based Healthcare Collaborating Agency)
  • Published : 2013.12.31

Abstract

Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

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