Factors associated with the utilization of home hospice care at end-of-life in patients with cancer: a nationwide analysis

BACKGROUND: Demand for home hospice care has been increasing as it allows patients with end-stage disease to receive end-of-life care in a familiar environment. This study aimed to investigate the factors associated with home hospice utilization among patients with end-stage cancer who utilized hospice services. METHODS: This study employed a nationwide, retrospective analysis of data collected from the National Hospice and Palliative Care (NHPC) registry in South Korea. Data for patients with end-stage cancer who utilized hospice services were collected from 2017 to 2024. Sociodemographic and health-related factors associated with home hospice utilization were analyzed using multivariate logistic regression. RESULTS: Of the 130 331 individuals analyzed, 9363 (7.2%) received home hospice care. Compared to individuals with non-family caregivers, those whose primary caregivers were their married spouses (OR 3.88, 95% CI 3.35-4.50) or other family members (OR 2.67, 95% CI 2.32-3.07) were more likely to utilize home hospice services. Additionally, individuals residing in rural areas were less likely to receive home hospice care than those in metropolitan areas (OR 0.68, 95% CI 0.65-0.72). The likelihood of hospice utilization was also lower in patients with impaired levels of consciousness and higher pain levels. CONCLUSION: The presence of a family caregiver is associated with a higher likelihood of receiving home hospice care. Contrastingly, residing in non-metropolitan areas, poor consciousness, and higher pain levels are linked to lower utilization of these services. Expanding home hospice care is important as the number of patients needing end-of-life care grows.