Hospital at home scheme did not increase likelihood of dying at home

One aim of home palliative care is to enable terminally ill patients to die at home if they so wish. In a randomised controlled trial of the Cambridge hospital at home scheme for palliative care Grande et al compared hospital at home with standard care in 229 patients (p 1472). Intention to treat analysis showed no significant difference between patient groups in the likelihood of dying at home. Many patients allocated to hospital at home, however, did not receive the service, and patients who were actually admitted to the hospital at home scheme were more likely to die at home than control patients, though it was unclear whether this was due to the characteristics of the patients. The study confirmed that there are many methodological difficulties associated with conducting randomised controlled trials in palliative care.

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Relevant Article

Does hospital at home for palliative care facilitate death at home? Randomised controlled trial

Gunn E Grande, Chris J Todd, Stephen I G Barclay, and Morag C Farquhar
BMJ 1999 319: 1472-1475. [Abstract] [Full Text] [PDF]