Author(s)

Yong Joo Rhee^1,2*, Yoon-Hee Tae³, Yong Joo Lee⁴, Soomok Jang³, Joachim Cohen⁵, Young-Soon Choi³

¹Department of Health Sciences, Dongduk Women’s University, Seoul, South Korea.
²Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
³National Health Insurance Service, Wonju, Kangwon-do, South Korea.
⁴Department of Palliative Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul, South Korea.
⁵Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium.

Background: Location of death has been used to examine an indicator for good death. This study aims to examine location of death among patients with three major cancers (gastric, liver, and lung) and other factors associated with location of death in South Korea. Methods: We selected the medical and pharmacy claims data for health services and location of death among the 42,596 decedents with cancer (lung 16,632, liver 15,872, gastric 10,092) from 2009 to 2013. We used logistic regressions to identify factors associated with home death. Outcome measures are locations of death (hospital, outpatient clinics or emergency room and home). Results: Only 8.9% died at home whereas 46.5% died in hospital as inpatients. Patients with more than one comorbid cancer or receivers for any supportive care were significantly more likely to die in hospital. Female and younger than 55 years old liver cancer patients were associated with home death. Patients living in metropolitan area, or paying more insurance premium, or being public aid beneficiaries, were associated with home death. Conclusions: The supportive care service use prior to death was significantly associated with increasing odds to hospital death. Being older than 75, or having multiple cancers was significant factors associated with hospital death, whereas living in metropolitan area, lower income or emergency visit were significant factors with home death. These findings are opposite to what is found, as the palliative care and hospice is predominantly hospital-centered. The findings emphasize a need to available end-of-life care in community for dying patients.

Supportive Care, Location of Death, National Health Insurance Program (NHI), Cancer, End-of-Life Care

Rhee, Y. , Tae, Y. , Lee, Y. , Jang, S. , Cohen, J. and Choi, Y. (2019) A Study on Locations of Death and Factors Associated with Death among Cancer Patients in South Korea. Journal of Biosciences and Medicines, 7, 26-41. doi: 10.4236/jbm.2019.72003.