PDF(Pubmed)
Abstract：
Introduction Most people would prefer end-of-life care to be provided at home. Although Japan has tried to promote home care and end-of-life care, very few people die at home in Japan. On the other hand, deaths at home are not necessarily attended deaths at home by end-of-life care because they include many deaths, such as deaths from external causes and solitary deaths. We obtained the data on the number of postmortem examinations at home in the main areas of Osaka City and calculated the estimated number of attended deaths at home by subtracting the number of postmortem examinations at home from the number of total deaths at home. We analyzed the contribution of medical resources to end-of-life care from a forensic perspective for a closer analysis of the actual situation. Methods The data about the population, the number of total deaths, deaths at home, and medical resources related to home care in Osaka City was obtained from the website of a public institution in Japan. The data about the number of postmortem examinations in Osaka City was obtained from the Osaka Medical Examiner\'s Office. The estimated number of attended deaths at home was calculated by subtracting postmortem examinations at home from total deaths at home. We conducted univariate and multivariate analyses between the number of medical resources and the prevalence of attended deaths at home. Results In the univariate analysis of the prevalence of attended deaths at home, a high positive correlation was observed in \"doctors,\" \"total clinics,\" \"clinics except HCSC,\" and \"general beds.\" A high negative correlation was observed in \"long-term care beds.\" In the multivariate analysis, a positive coefficient was observed in \"clinics except HCSC,\" and a negative one was observed in \"HCSC or HCSH.\" Conclusion The policy of shifting general clinics and hospitals to HCSC and HCSH may not be as effective for end-of-life care because the criteria do not include any restrictions on the number or use of beds. However, general clinics may have played an important role in end-of-life care, even if they were not HCSC.
摘要：
大多数人更喜欢在家中提供临终关怀。尽管日本试图推广家庭护理和临终关怀，在日本，很少有人死在家里。另一方面,在家中死亡不一定是通过临终关怀在家中死亡，因为它们包括许多死亡，例如外部原因死亡和单独死亡。我们获得了大阪市主要地区家中验尸次数的数据，并通过从家中总死亡人数中减去家中验尸次数，计算出估计的家中有人死亡人数。我们从法医学角度分析了医疗资源对临终关怀的贡献，以更深入地分析实际情况。方法采用人口数据,总死亡人数,在家里死亡,与大阪市家庭护理相关的医疗资源是从日本一家公共机构的网站获得的。有关大阪市验尸次数的数据是从大阪医学检查官办公室获得的。估计家中有人死的人数是通过从家中的总死亡人数中减去家中的验尸来计算的。我们对医疗资源的数量和在家参加死亡的患病率进行了单变量和多变量分析。结果在单因素分析中，家庭随诊死亡的患病率，在“医生”中观察到高度正相关，“总诊所，除HCSC外的诊所，“和”普通床。在长期护理床中观察到高度负相关。“在多变量分析中，除HCSC外，在诊所观察到一个正系数，在HCSC或HCSH中观察到阴性。“结论将普通诊所和医院改为HCSC和HCSH的政策可能对终末期护理无效，因为标准不包括对床位数量或使用的任何限制。然而,普通诊所可能在临终关怀中发挥了重要作用，即使他们不是HCSC。
