Factors Associated with Place of Death in Koprean Patients with Terminal Cancer

Abstract

Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and<br/><b>Methods</b>: We recruited 702 consecutive patients (≥18 years) from 12 centers during July 2005 to October 2006,and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patientsto the POD using the 2005-2009 death certificate data of Korea’s National Statistical Office. The primary outcomevariable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluatedusing univariate and multivariate analyses. <br/><b>Results</b>: Most patients died in a hospital (91.5%, n=441) and age,education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancerawareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 ofpatients, and education and preference for place of terminal care of caregivers were significant predictors inunivariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care asthe terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers whowere highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. <br/><b>Conclusions</b>: Most of the terminalcancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preferenceof both the patient and caregiver for hospital/palliative care as the terminal care option and higher educationof the caregiver.