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A Comparison of the Survival, Place of Death, and Medical Utilization of Terminal Patients Receiving Hospital-Based and Community-Based Palliative Home Care: A Retrospective and Propensity Score Matching Cohort Study

Author

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  • Cheng-Pei Lin

    (Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
    Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE5 9PJ, UK)

  • Min-Shiow Tsay

    (Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan)

  • Yi-Hui Chang

    (Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan)

  • Hung-Cheng Chen

    (Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan)

  • Ching-Yu Wang

    (Social Work Office, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan)

  • Yun-Shiuan Chuang

    (Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan)

  • Chien-Yi Wu

    (Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
    Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan)

Abstract

Evidence shows that community-based palliative home care (PHC) provision enhances continuous care and improves patient outcomes. This study compared patient survival, place of death, and medical utilization in community- versus hospital-based PHC. A retrospective cohort study was conducted of patients aged over 18 referred to either community- or hospital-based PHC from May to December 2018 at a tertiary hospital and surrounding communities in Southern Taiwan. A descriptive analysis, Chi-square test, t -test, and Log-rank test were used for the data analysis of 131 hospital-based PHC patients and 43 community-based PHC patients, with 42 paired patient datasets analyzed after propensity score matching. More nurse visits ( p = 0.02), fewer emergency-room visits ( p = 0.01), and a shorter waiting time to access PHC ( p = 0.02) were found in the community group. There was no difference in the duration of survival and hospitalization between groups. Most hospital-based patients (57%) died in hospice wards, while most community-based patients died at home (52%). Community-based PHC is comparable to hospital-based PHC in Taiwan. Although it has fewer staffing and training requirements, it is an alternative for terminal patients to meet the growing end-of-life care demand.

Suggested Citation

  • Cheng-Pei Lin & Min-Shiow Tsay & Yi-Hui Chang & Hung-Cheng Chen & Ching-Yu Wang & Yun-Shiuan Chuang & Chien-Yi Wu, 2021. "A Comparison of the Survival, Place of Death, and Medical Utilization of Terminal Patients Receiving Hospital-Based and Community-Based Palliative Home Care: A Retrospective and Propensity Score Match," IJERPH, MDPI, vol. 18(14), pages 1-11, July.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:14:p:7272-:d:590075
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    Cited by:

    1. Chien-Yi Wu & Yu-Hsuan Wu & Yi-Hui Chang & Min-Shiow Tsay & Hung-Cheng Chen & Hui-Ya Hsieh, 2021. "Community Nurses’ Preparations for and Challenges in Providing Palliative Home Care: A Qualitative Study," IJERPH, MDPI, vol. 18(22), pages 1-11, November.

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