Table 3.
A. Primary outcome measure | ||
Acute healthcare utilization in the last year of life | ||
Author, year | Outcome of interest | Results |
Toscani 2015 [40] | Physicians feel it difficult to decide for patients’ hospitalization (when patients’ prognosis of survival <= 15 days) |
HHC group vs. Nursing home care group 25.5% vs. 3.1%, p < 0.001 |
Mitchell 2004 [42] | Hospitalization within 90 days prior to the last Minimum Data Set assessment |
HHC group vs. Nursing home care group 31.5% vs. 43.7%, p < 0.001 |
Emergency department visit within 90 days prior to their last Minimum Data Set assessment | 13.1% vs. 11.4%, p = 0.41 | |
Procedures use | ||
1. Oxygen therapy within 14 days prior to their last Minimum Data Set assessment | 12.5% vs. 24.4%, p < 0.001 | |
2. Feeding tube (time frame not mentioned) | 11.9% vs. 27.2%, p < 0.001 | |
3. Intravenous therapy | 2.8% vs. 3.6%, p = 0.52 | |
4. Foley catheter | 15.8% vs. 29.4%, p < 0.001 | |
Medication use within 7 days prior to their last Minimum Data Set assessment | ||
1. Antipsychotic | 19.7% vs. 22.7%, p = 0.35 | |
2. Antianxiety | 20.7% vs. 15.9%, p = 0.05 | |
3. Antidepressant | 24.7% vs. 21.5%, p = 0.21 | |
Jennings 2019 [41] |
Hospitalization in the last 6 months 1. Any hospitalization |
HHC with POLST vs. HHC without POLST group 43% vs. 31%, p = 0.04 |
2. > 1 Hospitalization | 22% vs. 12%, p = 0.02 | |
3. Length of stay in hospital, median (interquartile range) | 5.8 (3.7–8.3) days vs. 4.1 (3.1–8.9) days, p = 0.22 | |
Emergency department visit in the last 6 months | ||
1. Any emergency department visit | 29% vs. 23%, p = 0.27 | |
Intensive care unit admission in the last 6 months | ||
1. Any intensive care unit admission | 6% vs. 4%, p = 0.62 | |
2. Length of stay in intensive care unit, median (interquartile range) | 2.0 (1.0–3.4) days vs. 5.8 (0.4–11.7) days, p = 0.41 | |
B. Secondary outcome measures | ||
Hospice and palliative care use | ||
Author, publication year | Outcome of interest | Results |
Toscani 2015 [40] | Physicians feel it difficult to decide for deep or terminal sedation |
HHC group vs. Nursing home care group 0.7% vs. 1.41%, p = 0.49 |
Purpose of all the decisions made for | ||
Reduce symptoms/suffering | 57% vs. 81.1% | |
Avoid/stop futile treatments | 10.3% vs. 8% | |
Improving the quality of death by minimizing suffering | 0% vs. 1.6% | |
Mitchell 2004 [42] | Hospice care referral any time prior to death |
HHC group vs. Nursing home care group 13.1% vs. 5.7%, p < 0.001 |
Jennings 2019 [41] | Hospice care discussion or consultation in the last 6 months of life |
HHC with POLST vs. HHC without POLST group 78% vs. 64%, p = 0.01 |
Died in hospice care | 74% vs. 62%, p = 0.03 | |
Wilson 2015 [44] | Hospice use |
House Calls group vs. Control group 22.9% vs. 8.9%, p < 0.05 |
Advance care planning | ||
Author, publication year | Outcome of interest | Results |
Mitchell 2004 [42] | Advance directive any time prior to death |
HHC group vs. Nursing home care group 39.4% vs. 57.4%, p < 0.001 |
Place of death | ||
Author, publication year | Outcome of interest | Results |
Jennings 2019 [41] | Home death |
HHC with POLST vs. HHC without POLST group 70% vs. 59%, p = 0.04 |
Arai 2020 [43] | Place of death (within 90 days after fever onset) |
HHC group vs. Hospitalized group 12.5% died (at home) vs. 33.3% died (in hospital) |
HHC home healthcare, POLST Physician Orders for Life-Sustaining Treatment