Patterns of end-of-life care use in Japan: health care and long-term-care use and socioeconomic and cultural characteristics in community

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Use of services at hospitals, long-term-care institutions, or homes in the "end-of-life" is influenced by availability of home care services and healthcare services, community connectedness, living conditions, and other factors. We conducted 1) analysis of community and regional indicators related to end-of-life care use, 2) surveys on healthcare use among general citizens, 3) surveys on current services by healthcare and long-term-care service providers, 4) analysis of an anonymously linked database of use of health-care and long-term-care according to public insurance schemes, in a city with a population of eighty-seven thousand. Service use in the last 24 months of 2,047 individuals who died during three years from April 1, 2010 to March 31, 2013 were analyzed. Ten patterns of health and long-term care use were demonstrated by duration of care use (0-1 month, 1-12 months, 13-24 months before death), care settings (home, long-term-care facility, hospital)