ArticlePalliative & supportive care2026
Impact of home healthcare reform on place of death for people with dementia: A nationwide cohort study accounting for cultural factors of impending death discharge.
Article in Palliative & supportive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough home is frequently the preferred place of death, little is known regarding how home healthcare (HHC) influences this outcome for people with dementia (PWD), particularly within Asian contexts. This study investigates the impact of HHC and its 2016 "Integrated Home-Based Medical Care" reform on home death in Taiwan, explicitly accounting for the cultural phenomenon of "impending death discharge."
methodsThis nationwide retrospective cohort study utilized Taiwan's National Health Insurance Research Database. We identified PWD decedents from 2011 to 2022 and conducted a nested case-control analysis. Cases (home deaths) and controls (hospital deaths) were matched 1:1 using propensity scores to balance demographics and health status. HHC models included pre-2016 primary HHC, post-2016 primary HHC, and the reformed "HBPC Plus" (Home-Based Primary Care Plus). The outcome was adjusted to include patients discharged terminally to die at home, reflecting distinctive cultural practices.
resultsAmong 209,468 decedents, 95,594 were selected after matching. Overall, HHC use was associated with higher odds of home death (adjusted odds ratio [aOR]: 1.17; 95% CI: 1.13-1.21). The reformed HBPC Plus program showed the strongest association compared to pre-2016 primary HHC (aOR: 1.63; 95% CI: 1.34-1.98). Crucially, this association strengthened further when accounting for impending death discharge (aOR: 1.82; 95% CI: 1.40-2.35). Higher visit frequency and services from hospital-based teams were also significantly linked to home death.
conclusionsHHC significantly increases the likelihood of home death among PWD in culturally influenced contexts. The 2016 reform, particularly the HBPC Plus program, proved highly effective. Policy components like flexible visit frequencies and enhanced hospital-physician coordination appear vital for supporting end-of-life care at home, offering key insights for policy planning in aging societies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.