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Table 2 Significant factors associated with the final place of care in bivariate analysis

From: Predictors of the final place of care of patients with advanced cancer receiving integrated home-based palliative care: a retrospective cohort study

Variables

Final place of care

Adjusted P-valuea

Home

(N = 209)

Inpatient hospice

(N = 85)

Hospital

(N = 60)

Age (years)

    

Median (IQR)

79 (70–86)

71 (65–81)

71 (64–80)

< 0.0001b

Mean (SD)

77.7 (11.6)

71.6 (12.0)

72.3 (9.9)

< 0.0001c

Gender

    

Male

96 (45.9)

46 (54.1)

39 (65.0)

0.252b

Female

113 (54.1)

39 (45.9)

21 (35.0)

0.014c

Marital status

    

Single

8 (3.8)

18 (21.2)

6 (10.0)

 

Married

100 (47.8)

38 (44.7)

40 (66.7)

 

Divorced

7 (3.3)

9 (10.6)

2 (3.3)

<0.0001b

Widowed

94 (45.0)

20 (23.5)

12 (20.0)

0.003c

Housing type

    

Rental

11 (5.3)

14 (16.5)

6 (10.0)

 

Public

169 (80.9)

68 (80.0)

50 (83.3)

 

Private condominium

15 (7.2)

2 (2.4)

2 (3.3)

0.002b

Private landed housing

14 (6.7)

1 (1.2)

2 (3.3)

0.300c

Government financial support level

    

High

117 (56.0)

67 (78.8)

33 (55.0)

 

Medium

20 (9.6)

7 (8.2)

9 (15.0)

 

Low

23 (11.0)

5 (5.9)

7 (11.7)

0.001b

No support

49 (23.4)

6 (7.1)

11 (18.3)

0.605c

Cancer site

    

Brain

6 (2.9)

1 (1.2)

2 (3.3)

 

Head and neck

3 (1.4)

5 (5.9)

5 (8.3)

 

Gastrointestinal system

54 (25.8)

27 (31.7)

14 (23.3)

 

Hepatobiliary pancreatic system

36 (17.2)

15 (17.6)

14 (23.3)

 

Breast

18 (8.6)

2 (2.4)

4 (6.7)

 

Gynecological

3 (1.4)

0

0

 

Genitourinary

12 (5.7)

5 (5.9)

3 (5.0)

 

Hematological

10 (4.8)

2 (2.4)

1 (1.7)

 

Prostate

5 (2.4)

2 (2.4)

3 (5.0)

 

Skin

0

2 (2.4)

1 (1.7)

 

Lung

50 (23.9)

17 (20.0)

8 (13.3)

 

Multiple sites

4 (1.9)

4 (4.7)

2 (3.3)

 

Unknown

8 (3.8)

1 (1.2)

2 (3.3)

0.024b

Others

0

2 (2.4)

1 (1.7)

0.001c

Cardiovascular disease

72 (34.4)

20 (23.5)

6 (10.0)

0.091b

< 0.0001c

Dementia

35 (16.7)

5 (5.9)

1 (1.7)

0.023b

0.005c

Main caregiver availability

207 (99.0)

61 (71.8)

53 (88.3)

< 0.0001b

Family

72 (34.8)

38 (62.3)

34 (64.2)

< 0.0001c

Friend

0

2 (3.3)

2 (3.8)

 

Foreign domestic helper

129 (62.3)

21 (34.4)

15 (28.3)

< 0.0001b

Private/interim care nurse

6 (2.9)

0

2 (3.8)

< 0.0001c

Family caregiver age (years)

    

Median (IQR)

54 (47–62)

61.5 (50.5–69)

51.5 (45–65)

0.007b

Mean (SD)

53.6 (12.8)

58.5 (13.7)

54.2 (14.6)

0.932c

Patient’s PPOC

138 (66.0)

70 (82.4)

41 (68.3)

 

Home

135 (97.8)

31 (44.3)

21 (51.2)

 

Inpatient hospice

1 (0.7)

38 (54.3)

3 (7.3)

 

Hospital

1 (0.7)

0

16 (39.0)

 

No preference

0

1 (1.4)

0

< 0.0001b

Any institution

1 (0.7)

0

1 (2.4)

< 0.0001c

Patient’s PPOD

136 (65.1)

70 (82.4)

35 (58.3)

 

Home

130 (95.6)

33 (47.1)

25 (71.4)

 

Inpatient hospice

1 (0.7)

34 (48.6)

5 (14.3)

 

Hospital

1 (0.7)

0

2 (5.7)

 

No preference

3 (2.2)

3 (4.3)

1 (2.9)

< 0.0001b

Any institution

1 (0.7)

0

2 (5.7)

< 0.0001c

Family’s PPOC

207 (99.0)

72 (84.7)

47 (78.3)

 

Home

202 (97.6)

7 (9.7)

7 (14.9)

 

Inpatient hospice

3 (1.4)

65 (90.3)

14 (29.8)

 

Hospital

2 (1.0)

0

23 (48.9)

 

No preference

0

0

1 (2.1)

< 0.0001b

Any institution

0

0

2 (4.3)

< 0.0001c

Family’s PPOD

206 (98.6)

72 (84.7)

42 (70.0)

 

Home

196 (95.1)

8 (11.1)

16 (38.1)

 

Inpatient hospice

4 (1.9)

63 (87.5)

14 (33.3)

 

Hospital

2 (1.0)

0

8 (19.0)

 

No preference

4 (1.9)

1 (1.4)

2 (4.8)

< 0.0001b

Any institution

0

0

2 (4.8)

< 0.0001c

Duration of enrollment in the home-based care service (days)

    

Median (IQR)

59 (32–124)

92 (57–168)

63 (42.5–160)

< 0.0001b

Mean (SD)

93.7 (93.0)

130.1 (103.3)

107.6 (100.7)

0.080c

Number of emergency department visits

    

Median (IQR)

0

0 (0–1)

0 (0–1)

< 0.0001b

Mean (SD)

0.3 (0.8)

0.7 (1.0)

0.7 (1.4)

0.054c

Number of hospital admissions

    

Median (IQR)

0 (0–1)

1 (0–1)

0 (0–1)

< 0.0001b

Mean (SD)

0.4 (0.8)

0.9 (1.0)

0.8 (1.7)

0.196c

Average length of hospitalization (days)

    

Median (IQR)

0 (0–4)

5 (0–11)

0 (0–5.5)

< 0.0001b

Mean (SD)

2.8 (6.2)

8.8 (11.0)

4.5 (9.4)

0.205c

PPSv2 2 weeks before death or admission to the final place of care

    

10%

77 (36.8)

0

0

 

20%

45 (21.5)

3 (3.5)

4 (6.7)

 

30%

45 (21.5)

14 (16.5)

7 (11.7)

 

40%

21 (10.0)

25 (29.4)

11 (18.3)

 

50%

8 (3.8)

19 (22.4)

22 (36.7)

 

60%

4 (1.9)

4 (4.7)

8 (13.3)

 

70%

1 (0.5)

2 (2.4)

1 (1.7)

 

80%

0

0

1(1.7)

<0.0001b

Missing

8 (3.8)

18 (21.2)

6 (10.0)

<0.0001c

ESASr 2 weeks before death or admission to the final place of care

    

Pain

    

Median (IQR)

0 (0–2)

0 (0–3)

2.5 (0–3)

< 0.0001b

Mean (SD)

0.9 (1.7)

2.2 (2.7)

2.1 (2.4)

<0.0001c

Nausea

    

Median (IQR)

0

0

0

0.007b

Mean (SD)

0.2 (0.9)

0.6 (1.5)

0.6 (1.7)

0.047c

Depression

    

Median (IQR)

0

0

0

< 0.0001b

Mean (SD)

0.2 (0.8)

1.1 (2.1)

0.9 (2.2)

0.001c

Drowsiness

    

Median (IQR)

3 (0–8)

0 (0–5)

0 (0–3)

0.002b

Mean (SD)

4.1 (3.8)

2.5 (3.1)

2.0 (2.8)

< 0.0001c

Appetite

    

Median (IQR)

5 (0–9)

5 (3–6.5)

3 (0–5)

0.608b

Mean (SD)

4.6 (3.9)

4.3 (3.1)

3.1 (2.8)

0.015c

Well-being

    

Median (IQR)

0 (0–3)

3 (0–6)

3 (0–5)

0.001b

Mean (SD)

1.8 (2.5)

3.1 (2.9)

2.6 (2.7)

0.028c

  1. Results are reported as frequencies with percentages unless otherwise stated
  2. IQR, interquartile range; SD, standard deviation; PPOC, preferred place of care; PPOD, preferred place of death; PPSv2, Palliative performance scale v2 is a valid and reliable tool ranging from 0% (death) to 100% (normal function) for assessing the functional status of palliative care patients [36, 37]; ESASr, Edmonton symptom assessment scale is a psychometrically tested tool that uses a numeric rating scale ranging from 0 (no symptom) to 10 (worst) for measuring the symptom severity of nine symptoms (pain, fatigue, nausea, depression, anxiety, drowsiness, appetite, well-being and dyspnea). Additional symptoms can be recorded if present. Individual symptom scores are summed with a higher total score indicating worse symptom burden [38, 39]
  3. aTo control for type 1 error in multiple comparisons, Bonferroni adjustment was applied to the p-value. With three pairwise comparisons, the adjusted p-value for statistical significance was 0.017
  4. bAdjusted p-value when patients whose final place of care was in the inpatient hospice were compared to patients whose final place of care was at home
  5. cAdjusted p-value when patients whose final place of care was in the hospital were compared to patients whose final place of care was at home