Background: Dying in the preferred place is considered an indicator of the quality of end-of-life care. Advance care planning and home palliative care may increase the likelihood of dying at home, but it remains unclear whether the documentation of these preferences in clinical records is associated with the actual place of death. This study assessed whether the recording of patients’ preferred place of care or death was associated with the actual place of death among patients followed by home palliative care teams. Methods: We conducted a retrospective observational study with an exploratory approach that included adult patients who died in 2022 and were followed by a home palliative care team in Madrid, Spain. Data were extracted from electronic health records and analysed using bivariate tests and multivariable logistic regression. Results: A total of 464 patients were included (53% women; mean age 80.8 years). Overall, 82.5% of the patients died at home. Preferences were recorded for 64% of the patients; 97.6% preferred to die at home, and 89% died there. Documentation of preferences was not significantly associated with the place of death. Conclusions: Documentation alone was not independently associated with the place of death. These findings should be interpreted cautiously given the observational and exploratory design of the study and the limited explanatory power of the regression model. Notably, most patients expressed a preference to die at home, and most deaths also occurred at home. Recording preferences may still support advance care planning and patient-centred decision-making, but documentation should not be interpreted as sufficient in itself to influence place of death.
Reguillo et al. (Wed,) studied this question.