Among all pediatric hematologist-oncologists (PHOs) certificated by the Japanese Society of Pediatric Hematology/Oncology (JSPHO), 215 PHOs (70.0%) received $908,900 personal payments from 54 pharmaceutical companies between 2016 and 2019. Four-year combined average payments per author was $2,961 (standard deviation: $6,299). While the prevalence of physicians with payments was relatively stable during the study period with 40.4% and 44.6% in 2016 and 2019, the average annual personal payments increased nearly double from $559 in 2016 to $1,096 in 2019, respectively. Payments from the top five companies with the largest total payments accounted for 48.8% of total monetary values.

There are many challenges that can arise while providing home care to a terminally ill patient. Isolation of infected patients was used to prevent COVID-19 infection. In home care, where informal caregivers play an important role, such measures could result in the loss of caregivers.

Patients and their families are discouraged from the restrictions on hospital visits for coronavirus Infection control. This separation might further deteriorate the mental health of both vulnerable patients and their family members. Home care could be a preferable solution to this problem.