{"id":4676,"date":"2018-02-15T00:00:00","date_gmt":"2018-02-15T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/associations-between-physician-home-visits-for-the-dying-and-place-of-death-a-population-based-retrospective-cohort-study\/"},"modified":"2023-06-14T19:22:23","modified_gmt":"2023-06-14T23:22:23","slug":"associations-between-physician-home-visits-for-the-dying-and-place-of-death-a-population-based-retrospective-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/associations-between-physician-home-visits-for-the-dying-and-place-of-death-a-population-based-retrospective-cohort-study\/","title":{"rendered":"Associations between physician home visits for the dying and place of death: a population-based retrospective cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; While most individuals wish to die at home, the reality is that most will die in hospital.<\/p>\n<p><strong>Aim<\/strong> &#x2014; To determine whether receiving a physician home visit near the end-of-life leads to lower odds of death in a hospital.<\/p>\n<p><strong>Design<\/strong> &#x2014; Observational retrospective cohort study, examining location of death and healthcare in the last year of life.<\/p>\n<p><strong>Setting\/Participants<\/strong> &#x2014; Population-level study of Ontarians, a Canadian province with over 13 million residents. All decedents from April 1, 2010 to March 31, 2013 (n=264,754).<\/p>\n<p><strong>Results<\/strong> &#x2014; More than half of 264,754 decedents died in hospital: 45.7% died in an acute care hospital and 7.7% in complex continuing care. After adjustment for multiple factors &#8211; including patient illness, home care services, and days of being at home &#8211; receiving at least one physician home visit from a non-palliative care physician was associated with a 47% decreased odds (odds-ratio, 0.53; 95% CI: 0.51-0.55) of dying in a hospital. When a palliative care physician specialist was involved, the overall odds declined by 59% (odds ratio, 0.41; 95% CI: 0.39-0.43). The same model, adjusting for physician home visits, showed that receiving palliative home care was associated with a similar reduction (odds ratio, 0.49; 95% CI: 0.47-0.51).<\/p>\n<p><strong>Conclusion<\/strong> &#x2014; Location of death is strongly associated with end-of-life healthcare in the home. Less than one-third of the population, however, received end-of-life home care or a physician visit in their last year of life, revealing large room for improvement.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; While most individuals wish to die at home, the reality is that most will die in hospital. Aim &#x2014; To determine whether receiving a physician home visit near the end-of-life leads to lower odds of death in a hospital. Design &#x2014; Observational retrospective cohort study, examining location of death and healthcare in the [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-4676","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Tanuseputro P, Beach S, Chalifoux M, Wodchis WP, Hsu AT, Seow H, Manuel DG. <em>PLoS One.<\/em> 2018; 13(2):e0191322. Epub 2018 Feb 15.","source_url":"http:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0191322","ices_scientist":[1107,1135,1366,1323],"site":[],"research_program":[],"news_release":[7943],"journal_article":[],"atlas":[],"research_report":[],"infographic":[9480],"video":[],"downloads":null,"links":null,"sitecore_item_id":"3CE181F1-6633-4899-92E6-12B2FB2E8193","sitecore_item_name":"Associations-between-physician-home-visits-for-the-dying-and-place-of-death","sitecore_field_values":"{\n  \"__Valid from\": \"20180215T145407\",\n  \"Title\": \"Associations between physician home visits for the dying and place of death: a population-based retrospective cohort study\",\n  \"Short title\": \"Associations between physician home\",\n  \"Summary\": \"Location of death is strongly associated with end-of-life healthcare in the home.\",\n  \"Citation\": \"<p>Tanuseputro P, Beach S, Chalifoux M, Wodchis WP, Hsu AT, Seow H, Manuel DG. <em>PLoS One.<\/em> 2018; 13(2):e0191322. Epub 2018 Feb 15.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; While most individuals wish to die at home, the reality is that most will die in hospital.<\/p>n<p><strong>Aim<\/strong> &mdash; To determine whether receiving a physician home visit near the end-of-life leads to lower odds of death in a hospital.<\/p>n<p><strong>Design<\/strong> &mdash; Observational retrospective cohort study, examining location of death and healthcare in the last year of life.<\/p>n<p><strong>Setting\/Participants<\/strong> &mdash; Population-level study of Ontarians, a Canadian province with over 13 million residents. All decedents from April 1, 2010 to March 31, 2013 (n=264,754).<\/p>n<p><strong>Results<\/strong> &mdash; More than half of 264,754 decedents died in hospital: 45.7% died in an acute care hospital and 7.7% in complex continuing care. After adjustment for multiple factors - including patient illness, home care services, and days of being at home - receiving at least one physician home visit from a non-palliative care physician was associated with a 47% decreased odds (odds-ratio, 0.53; 95% CI: 0.51-0.55) of dying in a hospital. When a palliative care physician specialist was involved, the overall odds declined by 59% (odds ratio, 0.41; 95% CI: 0.39-0.43). The same model, adjusting for physician home visits, showed that receiving palliative home care was associated with a similar reduction (odds ratio, 0.49; 95% CI: 0.47-0.51).<\/p>n<p><strong>Conclusion<\/strong> &mdash; Location of death is strongly associated with end-of-life healthcare in the home. Less than one-third of the population, however, received end-of-life home care or a physician visit in their last year of life, revealing large room for improvement.<\/p>n<p><a href=\"http:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0191322\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": null,\n  \"ICES Locations\": null,\n  \"ICES Scientists\": \"{B9979611-1657-47B5-B80F-08815BA48831}|{26C6C411-14DA-4E2F-9D10-9564115ADE0A}|{2632D656-8FC2-42A0-9B94-8C2F49CF088E}|{3178B170-580F-4CCA-A2D4-687D1150C87C}\",\n  \"Posted Date\": \"20180215T000000\",\n  \"Show on Publications Landing Page\": \"1\",\n  \"In The News\": \"{839CBA56-CE31-41C0-A3DA-86F32009D821}\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2018\/February\/Associations-between-physician-home-visits-for-the-dying-and-place-of-death"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Associations between physician home visits for the dying and place of death: a population-based retrospective cohort study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; While most individuals wish to die at home, the reality is that most will die in hospital. 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