Hospice visit number affects ability to die at home

(HealthDay) -- Hospice patients with cancer are more likely to be able to die in the setting of their choice if they receive at least one hospice visit per day during the first four days of hospice care, according to research published online June 25 in the Journal of Clinical Oncology.

Neha Jeurkar, M.D., of the University of Pennsylvania Perelman School of Medicine in Lancaster, and colleagues conducted a retrospective, electronic health record-based cohort study involving 7,391 patients in three hospice programs in Pennsylvania, Florida, and Wisconsin. The authors sought to determine preferences and factors associated with an increased likelihood for cancer patients to die at home.

The researchers found that patients who preferred to die at home were more than twice as likely to die at home. Factors associated with an increased likelihood of patients who preferred to die at home actually dying at home included having at least one visit per day in the first four days of hospice care, being married, and having an advance directive. Cancer patients with a higher functional status or who were experiencing moderate or severe pain were significantly less likely to die at home.

"The results of this study add to our understanding of the factors that facilitate death at home and highlight the importance of early visits by hospice team members," the authors write.

Two study authors are employed by Suncoast Solutions, which developed the electronic health record used by the hospices in the study.

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