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Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
We identified factors associated with death at home for 28,828 hospice and non-hospice cancer patients in 13 counties of western Washington State. Hospice participation was found to be the variable most strongly associated with death at home. Admission to hospice appears to override the tendency for certain subgroups of patients, such as the extreme elderly and those diagnosed close to death, to die in an institutional setting. These findings are discussed with respect to the problem of selection bias.
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