Abstract 536P
Background
The number of cancer patients receiving home-based end-of-life care is an important indicator of the quality of care provided by home care clinics. This study explores how the economic and social circumstances of patients and caregivers influence home-based care.
Methods
A secondary analysis was conducted using the dataset (home based end-of-life care N=625, hospital care N=7603) comprehensive patient-based survey conducted by The Japan Hospice and Palliative Care Evaluation Study-4, and multivariate analysis (multiple logistic regression) was used to explore the impact of social factors of patients and caregivers on the success of home- based end-of-life care. The main objective of the analysis was to explore social factors in home-based end-of-life care, with hospital care as the control. Explanatory variables included 11 social factors of patients, such as age and gender, and 18 social factors of primary caregivers.
Results
For patients, medical expenses less than 100,000 yen (Odds ratio: OR 2.06), household income of 4 million yen or more (OR 0.67), desire for home care (OR 1.49), desire to die at home (OR 1.58), wish to die at home (OR 1.52), and lack of financial leeway (OR 0.72) were significant factors associated with home based end-of-life care. For caregivers, significant factors included male caregivers (OR 0.66), poor mental state of caregivers (OR 0.79), ability to provide daily care (OR 3.02), experience of caring for a deceased family member (OR 0.66), presence of alternative caregivers (OR 0.78), and cohabitation with caregivers (OR 1.47).
Conclusions
Patients' desires, social situations, primary caregivers' social situations, and mental states influence home-based end-of-life care.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.