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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

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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.
Keywords
STATISTICS, PREDICTORS, PREFERENCES, CANCER, HEALTH, END, OF-LIFE, HOSPITAL USE, EUROPEAN COUNTRIES, LIFE CARE

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Chicago
Pivodic, Lara, Koen Pardon, Lucas Morin, Julia Addington-Hall, Guido Miccinesi, Marylou Cardenas-Turanzas, Bregje Onwuteaka-Philipsen, et al. 2016. “Place of Death in the Population Dying from Diseases Indicative of Palliative Care Need: a Cross-national Population-level Study in 14 Countries.” Journal of Epidemiology and Community Health 70 (1): 17–24.
APA
Pivodic, L., Pardon, K., Morin, L., Addington-Hall, J., Miccinesi, G., Cardenas-Turanzas, M., Onwuteaka-Philipsen, B., et al. (2016). Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 70(1), 17–24.
Vancouver
1.
Pivodic L, Pardon K, Morin L, Addington-Hall J, Miccinesi G, Cardenas-Turanzas M, et al. Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH. 2016;70(1):17–24.
MLA
Pivodic, Lara, Koen Pardon, Lucas Morin, et al. “Place of Death in the Population Dying from Diseases Indicative of Palliative Care Need: a Cross-national Population-level Study in 14 Countries.” JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 70.1 (2016): 17–24. Print.
@article{7105302,
  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 {\textrangle}= 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.},
  author       = {Pivodic, Lara and Pardon, Koen and Morin, Lucas and Addington-Hall, Julia and Miccinesi, Guido and Cardenas-Turanzas, Marylou and Onwuteaka-Philipsen, Bregje and Naylor, Wayne and Ruiz Ramos, Miguel and Van den Block, Lieve and Wilson, Donna M and Loucka, Martin and Csikos, Agnes and Rhee, Yong Joo and Teno, Joan and Deliens, Luc and Houttekier, Dirk and Cohen, Joachim},
  issn         = {0143-005X},
  journal      = {JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH},
  keyword      = {STATISTICS,PREDICTORS,PREFERENCES,CANCER,HEALTH,END,OF-LIFE,HOSPITAL USE,EUROPEAN COUNTRIES,LIFE CARE},
  language     = {eng},
  number       = {1},
  pages        = {17--24},
  title        = {Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries},
  url          = {http://dx.doi.org/10.1136/jech-2014-205365},
  volume       = {70},
  year         = {2016},
}

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