Proportion of deaths in hospital in European countries: trends and associations from panel data (2005–2017)
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Journal ArticleDate:
2021Access:
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Jiang, J., May, P., Proportion of deaths in hospital in European countries: trends and associations from panel data (2005–2017), European Journal of Public Health, 202, https://doi.org/10.1093/eurpub/ckab169Download Item:
20210927 TARA version.pdf (Accepted for publication (author's copy) - Peer Reviewed) 1.269Mb
Abstract:
Background: End-of-life care attracts major policy interest. Place of death is an important metric of individual experience and health system performance. Most people prefer to die at home, but hospital is the most common place of death in high-income countries. Little is known about international trends in place of death over time.
Methods: We aimed to collate population-level data on place of death in Europe from 2005-2017, and to evaluate association with national characteristics and policy choices. We sought data on hospital as the place of death from the 32 European Economic Area countries. We identified national economic, societal, demographic and health system predictors from Eurostat, OECD and the WHO. We analysed these cross-national panel data using linear regression with panel-corrected standard errors.
Results: Our analytic dataset included 30 countries accounting for over 95% of Europe’s population. Average national proportion of deaths occurring in hospital in the study period ranged from 26% to 68%, with a median of 52%. Trends vary markedly by region and wealth, with low and decreasing rate in the North-West, and high and increasing prevalence in the South and East. Controlling for demographic and economic factors, strong palliative care provision and generous government finance of long-term care were associated with fewer hospital deaths.
Conclusions: We found modifiable policy choices associated with hospital mortality, as well as wider structural economic and societal factors. Policymakers can act to reduce the proportion of dying in hospital.
Sponsor
Grant Number
Health Research Board (HRB)
ARPP/2018/A/005
Author's Homepage:
http://people.tcd.ie/pemayDescription:
PUBLISHED
Author: May, Peter; Jingjing, Jiang
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Journal ArticleSeries/Report no:
European Journal of Public Health;Availability:
Full text availableSubject (TCD):
Ageing , Cancer , HOSPITAL MORTALITY , Health outcomes , Health policyDOI:
10.1093/eurpub/ckab169Licences: