Purpose: The number of homebound adults with serious illnesses is increasing. This study aimed to examine the healthcare needs and characteristics of patients who use a hospital-affiliated physician-led home-based medical care (HBMC) program and identify factors associated with emergency department (ED) visits in Korea. Materials and Methods: This retrospective observational study included patients who used a HBMC program at a tertiary hospital between 2020 and 2023. Patient characteristics and home healthcare needs were analyzed by disease category: cancer, advanced neurologic disease, and others. Multivariable logistic regression analysis was used to identify factors associated with ED visits within 30 days of a physician’s home visit. Results: A total of 600 patients were registered and received home visits; 58.5% had cancer and 29.7% had advanced neurologic diseases, e.g., amyotrophic lateral sclerosis. The median age was 72 years [interquartile range (IQR), 62.8–81.0], and 87.0% were dependent in daily activities. The median number of medications per patient was 6 (IQR, 3–10); 66.3% took ≥5 medications and 25.7% took ≥10 (excessive polypharmacy). Physicians provided not only physical examinations (100%) and symptom assessment (90.8%), but also home environment evaluation (86.7%), medical device management (62.0%), advanced care planning (40.7%), and acute health issue management (32.5%). Within 30 days, 19.2% of patients visited the ED. Excessive polypharmacy and cancer diagnosis were associated with increased ED visits. Conclusion Most patients who used the hospital-affiliated HBMC program had cancer, advanced neurologic disease, and polypharmacy. Targeted HBMC programs are needed for patients with serious illnesses living at home.

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCPOGC) is a rare, highly malignant pancreatic exocrine neoplasm. Here, we report a case of UCPOGC in a 58-year-old man who presented with abdominal pain and weight loss. Abdomen computed tomography (CT) revealed a 5cm sized pancreatic body mass with peripheral enhancement. Endoscopic ultrasound (EUS)-guided biopsy of the mass suggested a solid-pseudopapillary tumor of the pancreas with a marked degenerative change. Distal pancreatectomy and splenectomy were performed. The size of the mass was 5.4 × 4.8 cm and the cut surface showed necrosis and hemorrhage. A definite diagnosis of UCPOGC was made using the histopathology and immunohistochemical findings.
Abdomen ; Abdominal Pain ; Biopsy ; Carcinoma* ; Diagnosis ; Giant Cells* ; Hemorrhage ; Humans ; Middle Aged ; Necrosis ; Osteoclasts ; Pancreas* ; Pancreatectomy ; Splenectomy ; Ultrasonography ; Weight Loss