Lara Pivodic1, Koen Pardon1, Lucas Morin2, Julia Addington-Hall3, Guido Miccinesi4, Marylou Cardenas-Turanzas5, Bregje Onwuteaka-Philipsen6, Wayne Naylor7, Miguel Ruiz Ramos8, Lieve Van den Block1, Donna M Wilson9, Martin Loucka10, Agnes Csikos11, Yong Joo Rhee12, Joan Teno13, Luc Deliens14, Dirk Houttekier1, Joachim Cohen1. 1. Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium. 2. French National Observatory on End-of-Life Care, Paris, France Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 3. Faculty of Health Sciences, University of Southampton, Hampshire, UK. 4. ISPO, Cancer Prevention and Research Institute, Florence, Italy. 5. The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA. 6. EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. 7. Hospice Waikato, Hamilton, New Zealand. 8. Regional Ministry of Equality, Health and Social Policies in Andalusia, Seville, Spain. 9. Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. 10. Center for Palliative Care, Prague, Czech Republic. 11. University of Pécs Medical School, Pécs, Hungary. 12. Dongduk Women's University, Seoul, South Korea. 13. Brown University, School of Public Health, Providence, Rhode Island, USA. 14. Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium.
Abstract
BACKGROUND: Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differences in the place of death. METHODS: Death certificate data for all deaths in 2008 (age ≥1 year) in Belgium, Canada, the Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (Andalusia), the USA and Wales caused by cancer, heart/renal/liver failure, chronic obstructive pulmonary disease, diseases of the nervous system or HIV/AIDS were linked with national or regional healthcare statistics (N=2,220,997). RESULTS: 13% (Canada) to 53% (Mexico) of people died at home and 25% (the Netherlands) to 85% (South Korea) died in hospital. The strength and direction of associations between home death and cause of death, sociodemographic and healthcare availability factors differed between countries. Differences between countries in home versus hospital death were only partly explained by differences in these factors. CONCLUSIONS: The large differences between countries in and beyond Europe in the place of death of people in potential need of palliative care are not entirely attributable to sociodemographic characteristics, cause of death or availability of healthcare resources, which suggests that countries' palliative and end-of-life care policies may influence where people die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differences in the place of death. METHODS:Death certificate data for all deaths in 2008 (age ≥1 year) in Belgium, Canada, the Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (Andalusia), the USA and Wales caused by cancer, heart/renal/liver failure, chronic obstructive pulmonary disease, diseases of the nervous system or HIV/AIDS were linked with national or regional healthcare statistics (N=2,220,997). RESULTS: 13% (Canada) to 53% (Mexico) of people died at home and 25% (the Netherlands) to 85% (South Korea) died in hospital. The strength and direction of associations between home death and cause of death, sociodemographic and healthcare availability factors differed between countries. Differences between countries in home versus hospital death were only partly explained by differences in these factors. CONCLUSIONS: The large differences between countries in and beyond Europe in the place of death of people in potential need of palliative care are not entirely attributable to sociodemographic characteristics, cause of death or availability of healthcare resources, which suggests that countries' palliative and end-of-life care policies may influence where people die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Entities:
Keywords:
CHRONIC DI; DEATH CERTIFICATION; PALLIATIVE CARE; PUBLIC HEALTH
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