13. Time the patient spent at home: home palliative care versus usual care.
| Study | Analysis | Follow‐up | Significance and direction | Details |
|
Jordhøy 2000 Norway (high quality) |
Forwards from enrolment | Entire follow‐up (up to 2 years with mean survival 99 days for intervention patients and 127 days for controls) |
n.s. P value = 0.6 |
M percentage time at home Intervention: 65% Control: 63% |
| Backwards from death | Last month |
Percentage of time at home marginally significant difference favours intervention P value = 0.06 n.s. adjusted for other predictive factors (gender and living with spouse) P value = 0.15 Number of inpatient‐days marginally significant difference favours intervention adjusted for sex as only predictive factor P value = 0.06 |
M percentage time at home Intervention: 48% Control: 41% Percentage of patients with no inpatient‐days Intervention: 28/219 (13%) Control: 11/176 (6%) |
|
|
Grande 1999 UK |
Backwards from death | Last 2 weeks (based on primary care team report 6 weeks after death) |
n.s. Chi2 0.557 P value = 0.455 |
Percentage of patients who spent time at home Intervention: 82% Control: 77% |
|
Buckingham 1978 US |
Not stated | Not stated | Authors stated difference favouring intervention but statistical significance was not stated | "It is estimated that nonhospice patients spent 50 percent more time in either an acute care hospital or some other form of institutional setting than hospice patients" (Buckingham 1978) |
|
Axelsson 1998 Sweden |
Forwards from enrolment | Entire follow‐up (median 70 days for intervention patients and 55 days for controls) | Favours intervention P value < 0.05 |
Median percentage of time spent at home Intervention (n = 41): 86% (range 0% to 100%) Control (n = 15): 72% (range 0% to 100%) |
| Backwards from death | Last 2 months | n.s. |
Median number of days spent at home Intervention (n = 41): 44 days (range 0 to 60) Control (n = 15): 39 days (range 15 to 60) |
|
|
Greer 1986 (CBA) |
Backwards from death | Not stated (based on caregiver report 90‐120 days after death) |
Favours community‐based intervention "HC PCPs were significantly more likely than HB and CC PCPs to report that the patient had been able to remain at home as long as he/she wanted" (Greer 1986) |
Patient able to remain at home as long as she/he wanted (adjusted estimatesa) Community‐based intervention: 82% (SE 0.04) Hospital‐based intervention: 69% (SE 0.05) Control (conventional care): 56% (SE 0.09) |
CC: conventional care (control); HB: hospital‐based (hospital‐based intervention); HC: home care (community‐based intervention); M: mean; n.s.: non‐significant; PCP: primary care person; SE: standard error. aOutcomes adjusted for sample differences; standard errors based on a logistic regression equation.