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conferenceseries
.com
Volume 7, Issue 3 (Suppl)
J Palliat Care Med, an open access journal
ISSN: 2165-7386
Palliative Care 2017
June 21- 22, 2017
3
rd
International Conference on
June 21- 22, 2017 | Philadelphia, USA
Palliative Care & Hospice Nursing
CLINICALAND SOCIO-DEMOGRAPHIC PREDICTORS OF HOME HOSPICE PATIENTS DYING
AT HOME: A RETROSPECTIVE ANALYSIS OF HOSPICE CARE ASSOCIATION’S DATABASE IN
SINGAPORE
YeeSong Lee
a
, R Akhileswaran
b
, Marcus Ong Eng Hock
c
, Win Wah
d
, David Hui
e
, Sheryl Hui-Xian Ng
d
and
Gerald Koh
d
a
National University Health System (NUHS), Singapore
b
Khoo Teck Puat Hospital, Singapore
c
Singapore General Hospital, Singapore
d
National University of Singapore, Singapore
e
University of Texas, USA
Statement of the Problem:
Hospice care can be delivered in different settings but many patients choose to receive it at home because
of familiar surroundings. Despite their preferences, not every home hospice patient manages to die at home.
Objective:
The objective of this study is to examine the independent factors associated with home hospice patient dying at home.
Methodology:
Retrospective analysis of Hospice Care Association (HCA)’s database. HCA is the largest home hospice provider in
Singapore. The study included all patients who were admitted into home hospice service from 1st Jan 2004 to 31st Dec 2013. Cox
Proportional Hazards modeling with time as constant was used to study the relationship between independent variables and home
death.
Result:
19,721 patients were included in the study. Females (Adjusted Risk Ratio, ARR 1.09, 95% CI 1.04–1.15), older patients (ARR
1.01, 95% CI 1.00 - 1.01), shorter duration of home hospice stay (ARR 0.88, 95% CI 0.82–0.94), fewer episodes of hospitalization
(ARR 0.81, 95% CI 0.75– 0.86), living with caregivers (ARR 1.54, 95% CI 1.05–2.26), doctor (ARR 1.05, 95% CI 1.01–1.08) and nurse
(ARR 1.06, 95% CI 1.04–1.08) visits were positive predictors of dying-at-home. Diagnosis of cancer (ARR 0.93, 95% CI 0.86–1.00)
was a negative predictor of dying-at-home.
Conclusion and Significance:
Female, older age, living with a caregiver, non-cancer diagnosis, more doctor and nurse visits, shorter
duration of home hospice stays and fewer episodes of acute hospitalizations are predictive of dying-at-home for home hospice patients.
End of life care brings value and hope to patients who are at the last moment of their life. The evidence provided by this study which
was based in an urban and multicultural country will assist policy makers in making informed decisions and also contribute to the
body of knowledge in hospice care sector.
Biography
Yee Song Lee is a senior resident of the preventive medicine residency under the National University Health System Singapore. He has a medical degree from the
University of Nottingham and a MPH degree from the National University of Singapore. His professional interest is in health policy and healthcare management
with the goal of population health improvement. He has extensive experience of working in both the healthcare sectors in United Kingdom and Singapore. His
works in Singapore transcends different aspects of healthcare from policymaking at national level to managing community health organization. He is also involved
in the integration of health and social care sectors at the East and North of Singapore with the aim of delivering value-based care to patients living in institutions
and community.
every92002@yahoo.comYeeSong Lee et al., J Palliat Care Med 2017, 7:3(Suppl)
DOI: 10.4172/2165-7386-C1-008