Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries

Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death. Of 5,568,827 deaths, 5.8% were from lung cancer and 4.4% from chronic obstructive pulmonary disease. Among lung cancer decedents, home deaths ranged from 12.5% in South Korea to 57.1% in Mexico, while hospital deaths ranged from 27.5% in New Zealand to 77.4% in France. In chronic obstructive pulmonary disease patients, the proportion dying at home ranged from 10.4% in Canada to 55.4% in Mexico, while hospital deaths ranged from 41.8% in Mexico to 78.9% in South Korea. Controlling for age, sex, and marital status, patients with chronic obstructive pulmonary disease were significantly less likely die at home rather than in hospital in nine countries. Our study found in almost all countries that those dying from chronic obstructive pulmonary disease as compared with those from lung cancer are less likely to die at home and at a palliative care institution and more likely to die in a hospital or a nursing home. This might be due to less predictable disease trajectories and prognosis of death in chronic obstructive pulmonary disease.

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“…More details on the database and methods can also be found in other publications based on the IPoD database. 38–40 …”

Section: Methodsmentioning

confidence: 99%

Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data

Cohen

Beernaert

Block

et al. 2017

npj Prim Care Resp Med

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“…[5][6][7][8][9] Recent reviews have highlighted how many studies reporting preferred place of death included high proportions of respondents with no recorded or stated preference regarding where they would like to die. 10 11 In light of the most prevalent place of death in many countries being hospital, [12][13][14][15][16] the UK hospice movement has responded with the development of 'hospice at home' (H@H) services. These provide more intensive nursing care in the home than is usually available 17 seeking to enable patients with advanced illness considered to be approaching the end of life, to be cared for and to die at home, if that is their preference.…”

Section: How This Fits Inmentioning

confidence: 99%

Persistent inequalities in Hospice at Home provision

Buck

Webb

Moth

et al. 2018

BMJ Support Palliat Care

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“…Similar international variations are seen when cancer and non-cancer deaths 6 and other deaths that require palliative care are considered separately. 7 …”

Section: Introductionmentioning

confidence: 99%

Predictors of place of death in South West Scotland 2000–2010: Retrospective cohort study

et al. 2016

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Background:Surveys suggest most people would prefer to die in their own home.Aim:To examine predictors of place of death over an 11-year period between 2000 and 2010 in Dumfries and Galloway, south west Scotland.Design:Retrospective cohort study.Setting/Participants:19,697 Dumfries and Galloway residents who died in the region or elsewhere in Scotland. We explored the relation between age, gender, cause of death (cancer, respiratory, ischaemic heart disease, stroke and dementia) and place of death (acute hospital, cottage hospital, residential care and home) using regression models to show differences and trends. The main acute hospital in the region had a specialist palliative care unit.Results:Fewer people died in their own homes (23.2% vs 29.6%) in 2010 than in 2000. Between 2007 and 2010, men were more likely to die at home than women (p < 0.001), while both sexes were less likely to die at home as they became older (p < 0.001) and in successive calendar years (p < 0.003). Older people with dementia as the cause of death were particularly unlikely to die in an acute hospital and very likely to die in a residential home (p < 0.001). Between 2007 and 2010, an increasing proportion of acute hospital deaths occurred in the specialist palliative care unit (6% vs 11% of all deaths in the study).Conclusion:The proportion of people dying at home fell during our survey. Place of death was strongly associated with age, calendar year and cause of death. A mismatch remains between stated preference for place of death and where death occurs.

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Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries

Cited by 161 publications

References 31 publications

Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data

Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data

Persistent inequalities in Hospice at Home provision

Predictors of place of death in South West Scotland 2000–2010: Retrospective cohort study

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