Observational studyJournal of epidemiology2026
Changes in Home-visit Care Utilization and Outcomes During the Coronavirus Disease 2019 Pandemic: Comparison Between Patients With and Without Cancer.
Observational study in Journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
backgroundThe coronavirus disease 2019 (COVID-19) pandemic disrupted access to healthcare for homebound older adults, particularly those with cancer. We compared changes in the initiation and outcomes of physician home-visit care among older Japanese patients with and without cancer during the pandemic.
methodsWe conducted a retrospective observational study using national medical claims data of patients aged ≥65 years who began physician home visits between April 2018 and December 2020 in Japan. The proportions of all-cause death, in-home death, and at least one hospitalization within 90 days after the initiation of home-visit care were compared between the pre-pandemic (April 2018 to December 2019) and pandemic periods (January 2020 to December 2020), stratified by cancer diagnosis. Differences between the cancer and non-cancer groups were estimated using linear regression models with an interaction term for cancer status and pandemic period.
resultsAmong 509,718 patients (251,311 with cancer), the initiation of home-visit care increased in both groups during the pandemic. All-cause and in-home death rates increased and hospitalization rates decreased in both groups, with greater changes among patients with cancer: 1.6% (95% confidence interval [CI], 1.1-2.1) for all-cause death, 3.8% (95% CI, 3.4-4.3) for in-home death, and -2.9% (95% CI, -3.7 to -2.2) for hospitalization.
conclusionDuring the COVID-19 pandemic, physician home-visit care expanded, and patients with cancer showed a greater shift toward home-based end-of-life care. These findings highlight the need for targeted resource allocation strategies to support home-visit physicians caring for patients with cancer during public health emergencies.
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