Dirk Houttekier1, Joachim Cohen2, Thierry Pepersack3, Luc Deliens4. 1. 1 End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium dirk.houttekier@vub.ac.be. 2. 1 End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium. 3. 2 Department of Geriatrics, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. 4. 1 End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium 3 Department of Public and Occupational Health, EMGO Institute for Health and Care Research and Expertise Center for Palliative Care, VU University Medical Center, Amsterdam, the Netherlands.
Abstract
BACKGROUND: Most people prefer not to die in a hospital, and for those with palliative care needs, doing so may result in inappropriate care and poor outcomes. We examined place of death and factors associated with hospital death in a population eligible for palliative care. METHODS: We used death certificate data to identify deaths from conditions eligible for palliative care and to examine place of death and demographic, socioeconomic and environmental characteristics associated with hospital death in Belgium in 2008. RESULTS: Of all people eligible for palliative care (N = 44 229, i.e. 43.5% of all deaths), 51% died in hospital, 25% at home and 24% in long-term care settings. Of those officially living at home at the time of death, hospital death occurred in >60%; of those living in long-term care settings, this was 16%. Nine percent of those living at home alone at the time of death died in long-term care settings; of those living with others, this was 5%. In both, those living at home and those living in long-term care settings, hospital death was more likely in areas with higher availability of hospital beds and less likely in areas with higher availability of skilled nursing beds in long-term care settings. CONCLUSIONS: Hospital death is still common among those eligible for palliative care. The significant proportion of people living at home and dying in long-term care settings indicates the need for additional inpatient beds for terminal care in palliative care institutions.
BACKGROUND: Most people prefer not to die in a hospital, and for those with palliative care needs, doing so may result in inappropriate care and poor outcomes. We examined place of death and factors associated with hospital death in a population eligible for palliative care. METHODS: We used death certificate data to identify deaths from conditions eligible for palliative care and to examine place of death and demographic, socioeconomic and environmental characteristics associated with hospital death in Belgium in 2008. RESULTS: Of all people eligible for palliative care (N = 44 229, i.e. 43.5% of all deaths), 51% died in hospital, 25% at home and 24% in long-term care settings. Of those officially living at home at the time of death, hospital death occurred in >60%; of those living in long-term care settings, this was 16%. Nine percent of those living at home alone at the time of death died in long-term care settings; of those living with others, this was 5%. In both, those living at home and those living in long-term care settings, hospital death was more likely in areas with higher availability of hospital beds and less likely in areas with higher availability of skilled nursing beds in long-term care settings. CONCLUSIONS: Hospital death is still common among those eligible for palliative care. The significant proportion of people living at home and dying in long-term care settings indicates the need for additional inpatient beds for terminal care in palliative care institutions.
Authors: Anouk Overbeek; Lieve Van den Block; Ida J Korfage; Yolanda W H Penders; Agnes van der Heide; Judith A C Rietjens Journal: Eur J Public Health Date: 2017-10-01 Impact factor: 3.367
Authors: Joanna M Davies; Katherine E Sleeman; Javiera Leniz; Rebecca Wilson; Irene J Higginson; Julia Verne; Matthew Maddocks; Fliss E M Murtagh Journal: PLoS Med Date: 2019-04-23 Impact factor: 11.069