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Place of death: hospital-based advanced home care versus conventional care

A prospective study in palliative cancer care

Department of Otorhinolaryngology, Malmö University Hospital, Sweden and Unit of Applied Clinical Research, NTNU, Trondheim

Marit S Jordhøy

Unit of Applied Clinical Research, NTNU, Trondheim and Unit of Oncology and Palliative Care, Nordland Hospital, Bodø

Magnus Jannert

Department of Otorhinolaryngology, Malmö University Hospital, Malmö,

Peter Fayers

Department of Public Health, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen

Stein Kaasa

Department of Radiotherapy and Oncology, University Hospital of Trondheim, Unit of Applied Clinical Research NTNU, Trondheim

The purpose of this prospective nonrandomized study was to evaluate time spent at home, place of death and differences in sociodemographic and medical characteristics of patients, with cancer in palliative stage, receiving either hospital-based advanced home care (AHC), including 24-hour service by a multidisciplinary palliative care team or conventional hospital care (CC). Recruitment to the AHC group and to the study was a two-step procedure. The patients were assigned to either hospital-based AHC or CC according to their preferences. Following this, the patients were asked to participate in the study. Patients were eligible for the study if they had malignant disease, were older than 18 years and had a survival expectancy of 2-12 months. A total of 297 patients entered the study and 280 died during the study period of two and a half years, 117 in the AHC group and 163 in the CC group. Significantly more patients died at home in the AHC group (45%) compared with the CC group (10%). Preference for and referral to hospital-based AHC were not related to sociodemographic or medical characteristics. However, death at home was associated with living together with someone. Advanced hospital-based home care targeting seriously ill cancer patients with a wish to remain at home enable a substantial number of patients to die in the place they desire.

Key Words: home care services • palliative cancer care • place of death

Palliative Medicine, Vol. 18, No. 7, 585-593 (2004)
DOI: 10.1191/0269216304pm924oa


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