A population-based study on the specific locations of cancer deaths in Taiwan, 1997-2003

Introduction: In traditional Taiwanese culture, home death is generally regarded as implying a good death, as it is believed that the spirit will not be left to wander. The purpose of this study was to determine the place of death and identify the predictors of home deaths for all cancer patients in Taiwan. Materials and methods: We undertook a population-based study using death registration data on all cancer deaths which occurred in Taiwan between 1997 and 2003. In total, 173,187 eligible cancer deaths occurring during the period were examined. Results: Results revealed that around 60% of all cancer deaths in Taiwan between 1997 and 2003 occurred at home. Female cancer patients and those aged between 55 and 64 years, who were either married or widowed, living in less-urbanized areas of Taiwan, and areas with a low density of hospital beds, were found to be more likely to have died at home. Results from the logistic regression revealed that predictors for a home death included being female, aged more than 55 years, having been married, being employed, having respiratory cancer, living in central Taiwan, and living in less-urbanized areas. Discussion: There is increased awareness on a global scale of the desire among terminally ill patients to be able to die at home, and indeed, we are seeing greater efforts towards promoting home deaths; however, greater palliative home care services will be necessary if home deaths are to become a feasible option in Taiwan.