Factors affecting death at home in Japan

Despite the wish of the Japanese people to spend their final moments at home, the percentage of deaths at home among elderly is decreasing. Moreover, large variations in this rate were observed over the country. The present ecological study analyzed the relationship between the percentage of deaths at home for decedents aged 70 and over, and demographic, medical and socioeconomic characteristics. The data published in 1990 by the Japanese National Government were analyzed by correlation, principal-component, and multiple linear regression analyses. The results showed that the percentage of deaths at home for decedents aged 70 and over was positively associated with the number of persons per household, and the area of floor space per house. The divorce rate, the national tax per capita, and the mean length of hospitalization for stroke showed a negative association with the percentage of deaths at home. In the prefectures where the crude death rates of stroke and senility were high, elderly were more likely to die at home. These results suggested the importance of the number of family caregivers, and the housing conditions for terminal care at home. This research may lead to improve home medical assistance which is still underdeveloped in Japan.