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Trends in place of death in a small developing country : a population-level study using death certificate data

Nicholas Paul Jennings (UGent) , Kenneth Chambaere (UGent) , Luc Deliens (UGent) and Joachim Cohen (UGent)
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Organization
Abstract
Background: Valuable information for planning future end-of-life care (EOLC) services and care facilities can be gained by studying trends in place of death (POD). Scarce data exist on the POD in small developing countries. This study aims to examine shifts in the POD of all persons dying between 1999 and 2010 in Trinidad and Tobago, to draw conclusions about changes in the distribution of POD over time and the possible implications for EOLC practice and policy. Methods: A population-level analysis of routinely collected death certificate data of the most recent available fully coded years at the time of the study—1999 to 2010. Observed proportions for the POD of all deaths were standardised according to the age, sex and cause of death distribution in 1999. Trends for a subgroup of persons who died from causes indicative of a palliative care (PC) need were also examined. Results: The proportion of deaths in government hospitals increased from 48.9% to 55.4% and decreased from 38.7% to 29.7% at private homes. There was little variation between observed and standardised rates. The decrease in home deaths was stronger when the PC subcategory was considered, most notably from cancer. Conclusion: Internationally, the proportion of deaths at institutions is increasing. A national strategy on palliative and EOLC is needed to facilitate the increasing number of people who seek EOLC at government hospitals in Trinidad and Tobago, including an investigation into the reasons for the trend. Alternatives to accommodate out-of-hospital deaths can be considered.
Keywords
Public Health, Environmental and Occupational Health, Epidemiology, PALLIATIVE CARE PROGRAM, OF-LIFE CARE, PEOPLE DIE, CANCER, HOME, END, HOSPICE, POLICY

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MLA
Jennings, Nicholas Paul, et al. “Trends in Place of Death in a Small Developing Country : A Population-Level Study Using Death Certificate Data.” JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, vol. 74, no. 7, 2020, pp. 580–85, doi:10.1136/jech-2019-213285.
APA
Jennings, N. P., Chambaere, K., Deliens, L., & Cohen, J. (2020). Trends in place of death in a small developing country : a population-level study using death certificate data. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 74(7), 580–585. https://doi.org/10.1136/jech-2019-213285
Chicago author-date
Jennings, Nicholas Paul, Kenneth Chambaere, Luc Deliens, and Joachim Cohen. 2020. “Trends in Place of Death in a Small Developing Country : A Population-Level Study Using Death Certificate Data.” JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 74 (7): 580–85. https://doi.org/10.1136/jech-2019-213285.
Chicago author-date (all authors)
Jennings, Nicholas Paul, Kenneth Chambaere, Luc Deliens, and Joachim Cohen. 2020. “Trends in Place of Death in a Small Developing Country : A Population-Level Study Using Death Certificate Data.” JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH 74 (7): 580–585. doi:10.1136/jech-2019-213285.
Vancouver
1.
Jennings NP, Chambaere K, Deliens L, Cohen J. Trends in place of death in a small developing country : a population-level study using death certificate data. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH. 2020;74(7):580–5.
IEEE
[1]
N. P. Jennings, K. Chambaere, L. Deliens, and J. Cohen, “Trends in place of death in a small developing country : a population-level study using death certificate data,” JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, vol. 74, no. 7, pp. 580–585, 2020.
@article{8659853,
  abstract     = {Background: Valuable information for planning future end-of-life care (EOLC) services and care facilities can be gained by studying trends in place of death (POD). Scarce data exist on the POD in small developing countries. This study aims to examine shifts in the POD of all persons dying between 1999 and 2010 in Trinidad and Tobago, to draw conclusions about changes in the distribution of POD over time and the possible implications for EOLC practice and policy.

Methods: A population-level analysis of routinely collected death certificate data of the most recent available fully coded years at the time of the study—1999 to 2010. Observed proportions for the POD of all deaths were standardised according to the age, sex and cause of death distribution in 1999. Trends for a subgroup of persons who died from causes indicative of a palliative care (PC) need were also examined.

Results: The proportion of deaths in government hospitals increased from 48.9% to 55.4% and decreased from 38.7% to 29.7% at private homes. There was little variation between observed and standardised rates. The decrease in home deaths was stronger when the PC subcategory was considered, most notably from cancer.

Conclusion: Internationally, the proportion of deaths at institutions is increasing. A national strategy on palliative and EOLC is needed to facilitate the increasing number of people who seek EOLC at government hospitals in Trinidad and Tobago, including an investigation into the reasons for the trend. Alternatives to accommodate out-of-hospital deaths can be considered.},
  author       = {Jennings, Nicholas Paul and Chambaere, Kenneth and Deliens, Luc and Cohen, Joachim},
  issn         = {0143-005X},
  journal      = {JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH},
  keywords     = {Public Health,Environmental and Occupational Health,Epidemiology,PALLIATIVE CARE PROGRAM,OF-LIFE CARE,PEOPLE DIE,CANCER,HOME,END,HOSPICE,POLICY},
  language     = {eng},
  number       = {7},
  pages        = {580--585},
  title        = {Trends in place of death in a small developing country : a population-level study using death certificate data},
  url          = {http://dx.doi.org/10.1136/jech-2019-213285},
  volume       = {74},
  year         = {2020},
}

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