Real-world data on home end-of-life care for older adults with cancer: A retrospective claims data analysis

Background: Cancer incidence is expected to increase with population aging, making the availability of places for treating patients with terminal cancer a pressing issue. However, little is known about the actual state of home end-of-life care (HEC) in Japan.Objective: The objective of this study was to examine the real-world state of HEC for older adults with cancer.Methods: The Yokohama Original Medical Database was used to identify the cohort. Data of target patients was extracted based on three criteria: age >= 65 years, malignant neoplasm diagnosis, and having a specific billing code of HEC. Multivariable linear and logistic regression models were used to evaluate the association between age groups and HEC services or outcome indexes.Results: Overall, 1323 people (554 and 769 aged < 80 and >= 80 years, respectively; men, 59.2%) had planned to receive HEC. The < 80 years group had more frequent emergent home visits than the >= 80-year group (P < 0.001), but the number of monthly home visits was similar between the two groups (P = 0.267). The rate of emergent admission was 5.9% in the >= 80-year group, which was higher than that in the < 80-year group (3.1%; P = 0.018). Conversely, the rates of central venous nutrition and opioid use were higher in the < 80-year group than those in the >= 80-year group.Conclusions: This study reported patterns of use of HEC among older adults with cancer in the terminal stage. Our findings may provide the basis for providing HEC for older adults with cancer.