Cancer patients choosing to die at home tend to live longer than those who die in hospital, says a new study.
Oncologists shouldn’t hesitate to refer patients for home palliative care simply because less medical treatment may be provided, say the authors of the Japanese study published in the journal CANCER.
“Dying in the preferred place is one of the most important factors for a good death,” they say.
“More than half of all people would prefer to be cared for and die at home, and the quality of death and dying is actually superior at home versus a hospital.”
But dying at home is not achieved in many countries or happens only at a very late stage of the disease for reasons including a concern that the quality of medical treatment will be inferior and that survival might be shortened.
The researchers analysed 1582 patients receiving hospital-based palliative care and 487 receiving home-based palliative care.
They found patients who died at home had a survival time similar to or longer than those of patients who died in a hospital, even after adjusting for clinical and other factors.
For those with a prognosis of days, the median survival time for those at home was 13 days compared to nine in hospital, and those with a prognosis of weeks, the figures were 36 and 29.
There was no significant difference for those with a prognosis of months – 59 versus 62 days.
“Patients, families, and clinicians should be reassured that good home hospice care does not shorten patient life, and even may achieve longer survival,” said researcher Dr Jun Hamano.