Place of death of cancer patients in Israel: the experience of a 'home-care programme'

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Abstract
This is an analysis of the eventual place of death of 58 patients with advanced cancer, all of whom died over the course of one year following treatment at home by a home-care programme in an Israeli community. Seventeen (29%) died in their homes, 23 (40%) died in general hospitals and 18 (31 %) died in chronic hospitals. The correlation between place of death and the following factors was examined: the relationship between each patient and his primary care person (PCP), length of treatment by the home-care programme, age, sex, ethnic origin, degree of mobility at commencement of home care and principal symptoms. Only the degree of family relationship of the PCP showed significant correlation with the actual place of death of patients, whether at home or in hospital (p=0.03). None of the patients with a PCP of second-degree relationship died at home. The authors conclude that when the PCP is closely related to the patient and is accompanied by a home-care team trained to offer comprehensive assistance, two-thirds of the patients in an Israeli community could be spared chronic hospitalization and almost half of these could also eventually die at home.

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