Factors which affect Place of Death in Home Medical Care including Medical Resource Consumption, Nursing Care Level, and Disease

Okamoto Y, Koinuma M, Iriuchijima R, Akase T, Ara T, Fukuda S and Yamaguchi T

Published on: 2025-08-12

Abstract

Background: At the end stage of medical home care, the place of death is usually either at home or in a hospital. However, it does not always align with the patient’s wishes. Therefore, we are still seeking solutions to this issue.

Objective: The purpose of this study was to investigate and identify the patient-related factors that influence the place of death in home medical care in Japan.

Method: We conducted research involving 1,101 deceased patients who were under our clinic’s medical care.

Results: Of those, 735 patients died at home or in a nursing care facility, while 366 patients died in a hospital at the end of life. The total number of hospitalizations during the last year of life was significantly higher for patients who died in a hospital compared to those who died at home. The odds ratio for hospital death was 14, indicating a strong association between hospitalization and death in a hospital setting. Conversely, factors such as residence type (nursing care facility), nursing care level, and cancer had odds ratios of less than 1, suggesting these factors were associated with a higher likelihood of dying at home rather than in a hospital.

Conclusion: By understanding the patient-related factors that influence the place of death, we may be able to provide better medical care that aligns with a patient’s wishes or advance care planning, which could improve the quality and efficiency of home care.