A Cochrane review [Abstract] 1 included 4 studies; 3 RCTs (n=694) and one cluster randomized trial (n=434). Those receiving home-based end of life care were statistically significantly more likely to die at home compared with those receiving usual care (RR 1.31, 95% CI 1.12 to 1.52; 2 studies, n=539). Admission to hospital while receiving home-based end of life care varied between trials (range of RR 0.62, 95% CI 0.48 to 0.79, to RR 2.61, 95% CI 1.50 to 4.55). The effect on patient outcomes and control of symptoms was uncertain. Home-based end-of-life care slightly improved patient satisfaction at 1-month follow-up, with little or no difference at 6-month follow-up (2 studies). The effect on caregivers, staff, and health service costs was uncertain.
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