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Place of death of children with complex chronic conditions : cross-national study of 11 countries

(2017) EUROPEAN JOURNAL OF PEDIATRICS. 176(3). p.327-335
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Abstract
Cross-national understanding of place of death is crucial for health service systems for their provision of efficient and equal access to paediatric palliative care. The objectives of this population-level study were to examine where children with complex chronic conditions (CCC) die and to investigate associations between places of death and sex, cause of death and country. The study used death certificate data of all deceased 1- to 17-year-old children (n = 40,624) who died in 2008, in 11 European and non-European countries. Multivariable logistic regression was performed to determine associations between place of death and other factors. Between 24.4 and 75.3% of all children 1-17 years in the countries died of CCC. Of these, between 6.7 and 42.4% died at home. In Belgium and the USA, all deaths caused by CCC other than malignancies were less likely to occur at home, whereas in Mexico and South Korea, deaths caused by neuromuscular diseases were more likely to occur at home than malignancies. In Mexico (OR = 0.91, 95% CI: 0.83-1.00) and Sweden (OR = 0.35, 95% CI: 0.15-0.83), girls had a significantly lower chance of dying at home than boys. Conclusion: This study shows large cross-national variations in place of death. These variations may relate to health system-related infrastructures and policies, and differences in cultural values related to place of death, although this needs further investigation. The patterns found in this study can inform the development of paediatric palliative care programs internationally.
Keywords
Children, Complex chronic conditions, Cross-national, Paediatric palliative care, Place of death, Population-level, PEDIATRIC PALLIATIVE CARE, OF-LIFE CARE, EUROPEAN COUNTRIES, WASHINGTON-STATE, HOME, PROGRAM, CANCER, LOCATION, QUALITY, PARENTS

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Citation

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Chicago
Håkanson, Cecilia, Joakim Öhlén, Ulrika Kreicbergs, Marylou Cardenas-Turanzas, Donna M Wilson, Martin Loucka, Sandra Frache, et al. 2017. “Place of Death of Children with Complex Chronic Conditions : Cross-national Study of 11 Countries.” European Journal of Pediatrics 176 (3): 327–335.
APA
Håkanson, C., Öhlén, J., Kreicbergs, U., Cardenas-Turanzas, M., Wilson, D. M., Loucka, M., Frache, S., et al. (2017). Place of death of children with complex chronic conditions : cross-national study of 11 countries. EUROPEAN JOURNAL OF PEDIATRICS, 176(3), 327–335.
Vancouver
1.
Håkanson C, Öhlén J, Kreicbergs U, Cardenas-Turanzas M, Wilson DM, Loucka M, et al. Place of death of children with complex chronic conditions : cross-national study of 11 countries. EUROPEAN JOURNAL OF PEDIATRICS. 2017;176(3):327–35.
MLA
Håkanson, Cecilia, Joakim Öhlén, Ulrika Kreicbergs, et al. “Place of Death of Children with Complex Chronic Conditions : Cross-national Study of 11 Countries.” EUROPEAN JOURNAL OF PEDIATRICS 176.3 (2017): 327–335. Print.
@article{8502208,
  abstract     = {Cross-national understanding of place of death is crucial for health service systems for their provision of efficient and equal access to paediatric palliative care. The objectives of this population-level study were to examine where children with complex chronic conditions (CCC) die and to investigate associations between places of death and sex, cause of death and country. The study used death certificate data of all deceased 1- to 17-year-old children (n = 40,624) who died in 2008, in 11 European and non-European countries. Multivariable logistic regression was performed to determine associations between place of death and other factors. Between 24.4 and 75.3% of all children 1-17 years in the countries died of CCC. Of these, between 6.7 and 42.4% died at home. In Belgium and the USA, all deaths caused by CCC other than malignancies were less likely to occur at home, whereas in Mexico and South Korea, deaths caused by neuromuscular diseases were more likely to occur at home than malignancies. In Mexico (OR = 0.91, 95% CI: 0.83-1.00) and Sweden (OR = 0.35, 95% CI: 0.15-0.83), girls had a significantly lower chance of dying at home than boys. 
Conclusion: This study shows large cross-national variations in place of death. These variations may relate to health system-related infrastructures and policies, and differences in cultural values related to place of death, although this needs further investigation. The patterns found in this study can inform the development of paediatric palliative care programs internationally.},
  author       = {Håkanson, Cecilia and Öhlén, Joakim and Kreicbergs, Ulrika and Cardenas-Turanzas, Marylou and Wilson, Donna M and Loucka, Martin and Frache, Sandra and Giovannetti, Lucia and Naylor, Wayne and Rhee, YongJoo and Ramos, Miguel Ruiz and Teno, Joan and Beernaert, Kim and Deliens, Luc and Houttekier, Dirk and Cohen, Joachim},
  issn         = {0340-6199},
  journal      = {EUROPEAN JOURNAL OF PEDIATRICS},
  keywords     = {Children,Complex chronic conditions,Cross-national,Paediatric palliative care,Place of death,Population-level,PEDIATRIC PALLIATIVE CARE,OF-LIFE CARE,EUROPEAN COUNTRIES,WASHINGTON-STATE,HOME,PROGRAM,CANCER,LOCATION,QUALITY,PARENTS},
  language     = {eng},
  number       = {3},
  pages        = {327--335},
  title        = {Place of death of children with complex chronic conditions : cross-national study of 11 countries},
  url          = {http://dx.doi.org/10.1007/s00431-016-2837-0},
  volume       = {176},
  year         = {2017},
}

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