Factors associated with end‐of‐life by home‐visit nursing‐care providers in Japan
Geriatrics and Gerontology International
Published online on July 07, 2016
Abstract
Aim
Home‐visit nursing‐care services in Japan are expected to provide home hospice services for older patients with non‐cancer diseases. The aim of the present study was to examine factors that contribute to the provision of end‐of‐life care by home‐visit nursing‐care providers in Japan.
Methods
The present retrospective study was carried out using nationally representative cross‐sectional data from the 2007, 2010, and 2013 Survey of Institutions and Establishments for Long‐Term Care. A total of 138 008 randomly sampled home‐visit nursing‐care service users were included in this analysis. End‐of‐life care (study outcome) was defined as the provision of nursing‐care within the last month of life.
Results
Of the 138 008 patients at home, 2280 (1.7%) received home‐based nursing care within the last month of life, and end‐of‐life care was offered primarily to cancer patients (n = 1651; 72.4%). After accounting for patient characteristics, patients were more likely to receive end‐of‐life care when they used home‐visit nursing‐care providers that had a greater number of nursing staff or were located in a region with fewer hospital beds.
Conclusions
Among home‐visit nursing‐care providers, the nursing staff ratio and the availability of hospital beds were related to the provision of end‐of‐life care. Home‐visit nursing‐care providers should establish specialist hospice care teams with enhanced staffing ratios to allow for the adequate provision of home‐based end‐of‐life care. A community‐based network between home‐visit nursing‐care providers and hospitals should also be established to attain an integrated end‐of‐life care system for elderly populations in regions with more hospital beds. Geriatr Gerontol Int 2017; 17: 991–998.