目標：探討台灣慢性腎臟病人使用安寧療護的相關因素。方法：本研究使用衛生福利部資料科學中心之全人口檔，以死因是慢性腎衰竭者14，490位為研究對象。使用描述性統計描述研究對象基本人口學變項及使用安寧緩和療護，再以多元邏輯斯迴歸分析研究對象使用安寧療護的相關因素。結果：1，354位(9.34%)研究對象使用緩和醫療家庭諮詢會議，有1，743位(12.03%)有使用安寧療護。政策實施中期及近期死亡、已婚及投保地區中度都市化程度的慢性腎臟病人使用緩和醫療家庭諮詢會議的機率較高。政策實施中期及近期、有使用緩和醫療家庭諮詢會議、女性、75歲(含)以上、投保地區中度都市化程度、投保金額40，001元（含）以上、查爾森合併症指標分數為1分（含）以上的慢性腎臟病人使用安寧療護的機率較高。結論：慢性腎臟病人使用緩和醫療家庭諮詢會議及安寧療護的比率有限，建議衛生主管機關應針對男性、75歲以下、鄉村地區及收入較少的民眾持續推廣安寧療護的相關知識。

Objectives: To investigate the factors associated with in-home mortality among hospice home care patients in Taiwan. Methods: This population-based retrospective study employed data from the Health and Welfare Data Center’s archives spanning from 2011 to 2020. Participants were hospice home care patients who died during the study period. Descriptive statistics were employed to analyze variable distributions, whereas logistic regression was used to explore the factors associated with in-home mortality. Results: A total of 2,775 patients were included in the analysis, of whom 57.91% died at home. In-home mortality rates exhibited a decreasing trend over time, with 621 of 1,016 (61.12%), 581 of 1,024 (56.74%), and 405 of 735 (55.10%) patients dying at home during 2011–2014, 2015–2017, and 2018–2020, respectively. The results of the multiple logistic regression analysis revealed that earlier years of death, older age, married status, higher urbanization levels, non–low-income households, absence of emergency room visits within 3 months prior to death, and fewer days of hospice home care were associated with an increased likelihood of in-home mortality. Conclusions: This study demonstrated a declining in-home mortality rate over time. Regardless of the hospice care model employed, health authorities should promote the option of home-based end-of-life care to enhance in-home mortality rates and overall care quality in Taiwan.

慢性腎臟病；緩和醫療家庭諮詢會議；安寧療護

chronic kidney disease; family palliative care consultation; palliative care