TITLE:
A Study on Locations of Death and Factors Associated with Death among Cancer Patients in South Korea
AUTHORS:
Yong Joo Rhee, Yoon-Hee Tae, Yong Joo Lee, Soomok Jang, Joachim Cohen, Young-Soon Choi
KEYWORDS:
Supportive Care, Location of Death, National Health Insurance Program (NHI), Cancer, End-of-Life Care
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.7 No.2,
January
23,
2019
ABSTRACT: 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.