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. 2022 Jan 27;22:80. doi: 10.1186/s12877-022-02768-3

Table 3.

Effects of home healthcare on end-of-life outcomes in people with dementia

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