Characteristics of cancer patients dying at home during the COVID‐19 pandemic: A study based on vital statistics from 2015 to 2022 in Japan

Author:

Sun Yu123ORCID,Masuda Rie12,Taniguchi Yuta45,Iwagami Masao12,Sakata Nobuo67,Yoshie Satoru2891011,Komiyama Jun14,Yamagishi Kazumasa21213,Kihara Tomomi2512,Watanabe Taeko12,Takahashi Hideto114,Iso Hiroyasu512,Tamiya Nanako12

Affiliation:

1. Department of Health Services Research, Institute of Medicine University of Tsukuba Tsukuba Ibaraki Japan

2. Health Services Research and Development Center University of Tsukuba Tsukuba Ibaraki Japan

3. Department of Primary Care and Medical Education, Institute of Medicine University of Tsukuba Tsukuba Ibaraki Japan

4. Department of Health Services Research, Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Ibaraki Japan

5. Institute for Global Health Policy Research Bureau of International Health Cooperation, National Center for Global Health and Medicine Shinjuku‐ku Tokyo Japan

6. Heisei Medical Welfare Group Research Institute Shibuya‐ku Tokyo Japan

7. Department of Home Healthcare Setagaya Memorial Hospital Setagaya‐ku Tokyo Japan

8. Institute of Gerontology University of Tokyo Bunkyo‐ku Tokyo Japan

9. Institute for Future Initiatives University of Tokyo Bunkyo‐ku Tokyo Japan

10. Department of Health Policy and Management, School of Medicine Keio University Shinjuku‐ku Tokyo Japan

11. School of Medicine Hiroshima University Hiroshima City Hiroshima Japan

12. Department of Public Health Medicine, Institute of Medicine University of Tsukuba Tsukuba Ibaraki Japan

13. Department of Public Health, Graduate School of Medicine Juntendo University Bunkyo‐ku Tokyo Japan

14. Faculty of Pharmaceutical Sciences Teikyo Heisei University Nakano‐ku Tokyo Japan

Abstract

AbstractBackgroundThe coronavirus disease 2019 (COVID‐19) pandemic has markedly affected end‐of‐life care, notably increasing home deaths among cancer patients in Japan. This study investigated the characteristics of cancer patients who died at home during the pandemic and the associated factors before and during the pandemic.MethodsVital statistics from January 2015 to December 2022 were analyzed to evaluate trends in home deaths among cancer patients aged 0 to 113 years, pre‐pandemic (January 2015 to March 2020) and during the pandemic (April 2020 to December 2022). Home deaths were assessed by demographics, including age, sex, marital status, and residential location. Multivariable modified Poisson regression analyses were performed to identify factors associated with home deaths in both periods.ResultsAmong 3,010,374 individuals, 11.6% (226,571/1,959,304) and 20.8% (218,429/1,051,070) died at home before and during the pandemic, respectively. In subgroup analysis depicting the trend of in‐home deaths by patient characteristics, only the age group showed a differential trend: the proportion of in‐home deaths was higher among older people before the pandemic, whereas it was higher among younger people during the pandemic. The multivariable analysis revealed the excess risk of in‐home deaths among people aged ≥65 years before the pandemic and among those aged <65 years during the pandemic.ConclusionsThe pandemic has increased home‐based end‐of‐life care for terminal cancer patients, particularly younger individuals, possibly due to hospital visit restrictions. Ensuring sufficient resources for both home and hospital care is vital to allow individuals to receive end‐of‐life care in their preferred settings.

Funder

Ministry of Health

Publisher

Wiley

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