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.
We thank all the patients who participated in the trial. We also thank Eva Almqvist Wedeberg for her invaluable work as a research assistant. Supported by grants from
The Swedish Cancer Society (grants no. 3650-B95- 01XAC), The Vardal Foundation for Health Care Sciences and Allergy Research (grant no.V98 262), the SSSH Foundation, The Association for Cancer and Traffic Victims (grant no. C24405) and Malin University Hospital Funds.
- home care services
- palliative cancer care
- place of death
- RANDOMIZED CONTROLLED-TRIAL
- TERMINAL CARE
- PATIENTS DIE