{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:11:07Z","timestamp":1774588267198,"version":"3.50.1"},"reference-count":45,"publisher":"CAIRN.INFO","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:p>Introduction : En France, alors que 80 % de la population souhaite d\u00e9c\u00e9der \u00e0 domicile, la majorit\u00e9 des d\u00e9c\u00e8s ont lieu \u00e0 l\u2019h\u00f4pital. Afin d\u2019explorer cette discordance, nous avons \u00e9tudi\u00e9 les facteurs influen\u00e7ant le lieu de fin de vie des patients atteints de cancer et admis en HAD pour soins palliatifs. M\u00e9thodes : \u00c9tude r\u00e9trospective cas-t\u00e9moins \u00e0 partir de la cohorte des patients pris en charge en HAD de la Fondation \u0152uvre de la Croix Saint-Simon durant l\u2019ann\u00e9e 2022. R\u00e9sultats : Dans cette \u00e9tude, 385 patients ont \u00e9t\u00e9 inclus. Parmi eux, 49,9 % sont d\u00e9c\u00e9d\u00e9s \u00e0 domicile et 50,1 % \u00e0 l\u2019h\u00f4pital. L\u2019analyse multivari\u00e9e a identifi\u00e9 deux facteurs associ\u00e9s \u00e0 un d\u00e9c\u00e8s \u00e0 domicile : la pr\u00e9f\u00e9rence de l\u2019aidant principal pour un d\u00e9c\u00e8s \u00e0 domicile (OR 8,53, IC95 % [4,73-15,87], p&lt;0,001) et l\u2019existence d\u2019une prescription anticip\u00e9e (OR 15,07, IC95 % [5,81-47,40], p&lt;0,001). Avec une analyse par imputation multiple, deux variables suppl\u00e9mentaires ont \u00e9t\u00e9 identifi\u00e9es : l\u2019\u00e9tat fonctionnel alt\u00e9r\u00e9 du patient (score de Karnofsky 10-30 % vs 50-70 %, OR 1,15, IC95 % [1,01-1,30], p=0,04) associ\u00e9 \u00e0 un d\u00e9c\u00e8s \u00e0 domicile et la prescription de l\u2019HAD par un m\u00e9decin sp\u00e9cialiste en soins palliatifs ( vs m\u00e9decin hospitalier, OR 0,89, IC95 % [0,80-1,00], p=0,047, en faveur d\u2019un d\u00e9c\u00e8s \u00e0 l\u2019h\u00f4pital). Conclusions : Cette \u00e9tude a identifi\u00e9 quatre facteurs influen\u00e7ant le lieu de d\u00e9c\u00e8s : la pr\u00e9f\u00e9rence de l\u2019aidant principal, l\u2019existence de prescriptions anticip\u00e9es, l\u2019\u00e9tat fonctionnel du patient et la sp\u00e9cialit\u00e9 du m\u00e9decin prescripteur de l\u2019HAD. Conna\u00eetre ces facteurs est essentiel pour am\u00e9liorer le dialogue sur la fin de vie entre les professionnels de sant\u00e9, les patients et leurs familles. En France, afin de satisfaire le souhait soci\u00e9tal de fin de vie \u00e0 domicile, il est essentiel de renforcer les soins palliatifs \u00e0 domicile en optimisant la coordination entre ses diff\u00e9rents acteurs, en r\u00e9affirmant le r\u00f4le central du m\u00e9decin g\u00e9n\u00e9raliste et en soutenant le d\u00e9veloppement des HAD.<\/jats:p>","DOI":"10.3917\/spub.pr2.0074","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T10:18:26Z","timestamp":1751278706000},"page":"29-41","source":"Crossref","is-referenced-by-count":1,"title":["\u00c9tude des facteurs associ\u00e9s au lieu de d\u00e9c\u00e8s des patients atteints de cancer et en HAD pour soins palliatifs"],"prefix":"10.3917","volume":"vol. 37","author":[{"given":"Thomas","family":"Fauchier","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdel-Djalil","family":"Khemar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Catherine","family":"Cuny","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Dreyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2273","reference":[{"key":"rb1","unstructured":"1Minist\u00e8re de la Sant\u00e9 et de la Pr\u00e9vention. 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Home Hospitalization for Palliative Cancer Care: Factors Associated with Unplanned Hospital Admissions and Death in Hospital. BMC Palliat Care. d\u00e9c 2021;20(1):24.","DOI":"10.1186\/s12904-021-00720-7"},{"key":"rb23","doi-asserted-by":"crossref","unstructured":"23Poterre M, Gandrille N, Bellart B, Hullot S, Fouassier P, Ravon R, et al. Palli\u2019HAD : l\u2019\u00e9tude du parcours de fin de vie en hospitalisation \u00e0 domicile en \u00cele-de-France. M\u00e9decine palliative. mars 2023;22(2):77-83.","DOI":"10.1016\/j.medpal.2022.09.002"},{"key":"rb24","doi-asserted-by":"crossref","unstructured":"24Lee LC, Hu CC, Loh EW, Hwang SF. Factors Affecting the Place of Death Among Hospice Home Care Cancer Patients in Taiwan. Am J Hosp Palliat Care. mai 2014;31(3):300-6.","DOI":"10.1177\/1049909113487427"},{"key":"rb25","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2019-001932"},{"key":"rb26","doi-asserted-by":"crossref","unstructured":"26Bannon F, Cairnduff V, Fitzpatrick D, Blaney J, Gomes B, Gavin A, et al. Insights into the Factors Associated with Achieving the Preference of Home Death in Terminal Cancer: A National Population-based Study. Pall Supp Care. d\u00e9c 2018;16(6):749-55.","DOI":"10.1017\/S1478951517000876"},{"key":"rb27","doi-asserted-by":"crossref","unstructured":"27Nakamura S, Kuzuya M, Funaki Y, Matsui W, Ishiguro N. Factors Influencing Death at Home in Terminally Ill Cancer Patients. Geriatrics Gerontology Int. avr 2010;10(2):154-60.","DOI":"10.1111\/j.1447-0594.2009.00570.x"},{"key":"rb28","doi-asserted-by":"crossref","unstructured":"28Kern H, Corani G, Huber D, Vermes N, Zaffalon M, Varini M, et al. Impact on Place of Death in Cancer Patients: A Causal Exploration in Southern Switzerland. BMC Palliat Care. d\u00e9c 2020;19(1):160.","DOI":"10.1186\/s12904-020-00664-4"},{"key":"rb29","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030756"},{"key":"rb30","doi-asserted-by":"crossref","unstructured":"30Sun Z, Guerriere DN, De Oliveira C, Coyte PC. Temporal Trends in Place of Death for End\u2010of\u2010life Patients: Evidence from Toronto, Canada. Health Soc Care Community. sept 2020;28(5):1807-16.","DOI":"10.1111\/hsc.13007"},{"key":"rb31","doi-asserted-by":"crossref","unstructured":"31Nilsson J, Holgersson G, Ullenhag G, Holmgren M, Axelsson B, Carlsson T, et al. Socioeconomy as a Prognostic Factor for Location of Death in Swedish Palliative Cancer Patients. 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La visite \u00e0 domicile : perceptions des m\u00e9decins g\u00e9n\u00e9ralistes sur son \u00e9volution pass\u00e9e et \u00e0 venir [Th\u00e8se de doctorat]. Nancy, France: Universit\u00e9 de Lorraine; 2012."},{"key":"rb45","doi-asserted-by":"publisher","DOI":"10.1016\/S1773-035X(12)71441-7"}],"container-title":["Sant\u00e9 Publique"],"original-title":[],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T03:03:49Z","timestamp":1774580629000},"score":1,"resource":{"primary":{"URL":"https:\/\/stm.cairn.info\/revue-sante-publique-2025-3-page-29?lang=fr&ref=doi"}},"subtitle":[""],"short-title":[],"issued":{"date-parts":[[2025,10,6]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,10,6]]}},"URL":"https:\/\/doi.org\/10.3917\/spub.pr2.0074","relation":{},"ISSN":["0995-3914"],"issn-type":[{"value":"0995-3914","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,6]]}}}