Objective: The aim of this study is to explore the factors associated with the burden of home care for doctors. Methods: In July 2013 a survey was mailed to a cross-section of clinics and hospitals in Kobe City. Results: Questionnaires were sent to 1,589 clinics and hospitals and 899 (57%) responded. Of these, data from 807 respondents were available for analysis. The burden of home care was felt to be considerable for 30% and slight for 31% of respondents. Determinants associated with the burden of home care were; 80 years and older doctors (P=0.05), particular medical measures (P=0.036), building links with other medical facility or care staff (P=0.002), and ensuring the sufficient time and staff (P<0.001). Conclusion: The majority of doctors reported a burden associated with home care.

Objective：The aim of this study was to investigate the current status of home care provided by hospitals and clinics in Kobe City. Methods：In July 2013 a survey was mailed to a cross-section of all clinics and hospitals in Kobe City. Results：Questionnaires were sent to 1,589 clinics and hospitals and 899（57％）responded. Regular and urgent home visits by doctors were provided by 50％ and 65％ of respondents, respectively. End-of-life care for dying patients at home and in nursing homes was provided by 31％ and 18％ of respondents, respectively. The average time spent on home visits was 2.3±1.7 days per week. Care for cancer patients, participation in national palliative care lectures, and holding a discussion at the admitting hospital before discharge for home care, were performed by 23％, 7.0％, and 6.9％ of respondents, respectively. Conclusion：The majority of hospitals and clinics in Kobe City provided home care.

In recent years, the system for providing home medical care and palliative care has been improved, and the number of cancer patients who are treated at home until the end is increasing. The aim of this study was to investigate the circumstances of cancer patients who died at home and the presence of doctors and nurses at the moment of death. We conducted a prospective survey of end-oflife cancer patients receiving home visits from home care and palliative care clinics in Japan from 1st July to 31st December 2017. During the study period, we analyzed the mortality status of 676 patients who died in their homes, serviced by 45 clinics. Of these patients, 91% were living with families, 49% died on holidays or at night, and the doctor and nurse was present at the time of death in only 5.6% and 9.9% of cases, respectively. Most of the patients who died at home lived with their families, with few doctors and nurses present at the time of their patients’ death.