Preferred Place of Death in Serious Chronic Illness: Single-Center Study in Lebanon.

Résumé

CONTEXT: Preferred place of death (PPOD) reflects an essential component of patient-centered palliative care. Understanding preferences and their determinants is key to guiding health system planning and improving end-of-life care quality.OBJECTIVES: To identify the PPOD among patients with serious chronic illnesses in Lebanon and determine factors influencing this preference.METHODS: A cross-sectional study was conducted at a tertiary medical center in Lebanon between November 2020 and January 2022. Adults with serious chronic illnesses were identified using the "surprise question" approach. A structured interview collected demographic, medical, social, and psychosocial data, including PPOD. Logistic regression was used to identify predictors of preferring home versus hospital death.RESULTS: Among 165 participants, 58.8% expressed a preference to die at home, while 41.2% preferred a hospital setting. Preference for home death was associated with higher social support, older age, and having family caregivers, whereas preference for hospital death was associated with higher disease burden and dependency on medical technology. Spiritual well-being and socioeconomic factors showed no independent association after adjustment.CONCLUSION: Most Lebanese patients with serious illnesses wish to die at home, yet structural and medical barriers limit fulfillment of this preference. Integration of home-based palliative care services and financial coverage mechanisms are essential to align care with patient values and improve end-of-life outcomes.