A comparison of hospice and home care patients: patterns of referral, patient characteristics and predictors of place of death

A retrospective review was performed of all patients cared for by St Joseph's Hospice, Hackney, London, in either the hospice or the home care setting, during the first six months of 1988. Patients referred to the two services were compared and home care patients further analysed to establish predictors of those who could be successfully managed at home. The results showed that those patients referred to the home care service were younger and more likely to be married. Hospitals were more likely to refer to the hospice, while community services referred more often to home care. Home care patients were likely to have a longer prognosis but were more likely to be recorded as experiencing anxiety/depression at presentation. Patients referred for home care were significantly more likely to die at home than in hospital. Those who did die at home were more likely to be married, less likely to be described as their own main carer and less likely to have been recorded as suffering moderate/severe pain at presentation.