Abstract
Objective
Place of death, specifically the percentage who die in hospital or residential aged care, is largely unreported. This paper presents a cross-national comparison of location of death information from published reports and available data.
Methods
Reports of deaths occurring in hospitals, residential aged care facilities, and other locations for periods since 2001 were compiled.
Results
Over 16 million deaths are reported in 45 populations. Half reported 54 % or more of all deaths occurred in hospitals, ranging from Japan (78 %) to China (20 %). Of 21 populations reporting deaths of older people, a median of 18 % died in residential aged care, with percentages doubling with each 10-year increase in age, and 40 % higher among women.
Conclusions
This place of death study includes more populations than any other known. In many populations, residential aged care was an important site of death for older people, indicating the need to optimise models of end-of-life care in this setting. For many countries, more standardised reporting of place of death would inform policies and planning of services to support end-of-life care.
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Acknowledgments
We are extremely appreciative to the generous and helpful staffs of official information departments and ministries who have cooperated in providing information in emails, tables and online databases. We also acknowledge academics that assisted in sourcing data, including Dr. Silmara Gusso at the University of Auckland, New Zealand, and Dr. Heidy Leiva, Rancagua Regional Hospital, Chile. With one exception, all data were obtained without charge. We are also particularly grateful to Ann Peut also at AIHW, Canberra, who provided very valuable comments and assistance on several drafts of this paper. The Freemasons’ Department of Geriatric Medicine at the University of Auckland is supported by longstanding endowments and grants from Freemasons New Zealand and the Freemasons’ Roskill Foundation. Joanna Broad’s appointment is supported by grant 10/373 from the Health Research Council of New Zealand.
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Appendix: Sources of population data
Appendix: Sources of population data
Population and years reported | Total number of deaths in period | Number of deaths in people aged 65+ years (if stated) | Restrictions | Source of data: paper = academic paper, report = published report, database = access to electronic database, by request = table/data provided on request | Data source or reference | |
---|---|---|---|---|---|---|
1 | Albania 2009 | 15,662 | – | By request | INSTAT (Instituti I Statisitkave) (2010) | |
2 | Australia 2005 | 131,595 | 104,443 | – | By request | ABS (Australian Bureau of Statistics) (2010), AIHW (Australian Institute of Health and Welfare) (2009, 2011) |
3 | Austria 2009–10 | 154,580 | 127,289 | – | By request | Q: Statistick Austria (2011) |
4 | Belgium (Flanders) 2003 | 57,156 | – | Paper | Cohen et al. (2006) | |
5 | Belgium (Flanders) 2001 | 55,759 | 46,271 | – | Paper | Cohen et al. (2008) |
6 | Belgium 2005–07 | 195,612 | Aged 1 year or older | Paper | Houttekier et al. (2010) | |
7 | Botswana 2005–06 | 18,869 | Non-traumatic deaths only | Paper | Lazenby et al. (2010) | |
8 | Brazil 2009 | 1,083,399 | – | Database | IBGE (Brazilian Institute of Geography and Statistics) (2010) | |
9 | Canada 2004 | 171,094 | – | Paper | Wilson et al. (2009) | |
10 | Chile 2007–09 | 275,133 | – | By request | DEIS, Ministry of Health (2011) | |
11 | China 2004–05 | 868,484 | Surveillance of 158 counties | Report | Chen (2008) | |
12 | Croatia 2009 | 52,414 | 41,363 | – | By request | Croatian National Institute of Public Health (2011) |
13 | Cyprus 2007–09 | 15,757 | 12,678 | – | By request | Cyprus Ministry of Health (2011) |
14 | Czech Republic 2009 | 107,421 | 81,835 | – | Database | Czech Statistical Office (2011) |
15 | England and Wales 2008 | 509,090 | 421,074 | – | Report | National End-of-Life Care Programme (2010b) |
16 | England 2005–07 | 474,719 | 392,785 | – | Database | UK Statistics Authority (2009) |
17 | England 2007–09 | Not stated | – | Database | National End-of-Life Care Programme (2010a) | |
18 | Estonia 2008–10 | 28,708 | – | By request | Ministry of Social Affairs of Estonia (2011) | |
19 | France 2005–06 | 1,043,949 | 833,366 | – | Database | INSEE (Institut National de la Statistique et des Études Économiques) (2010, 2011) |
20 | Iceland 2007–09 | 5,932 | 4,875 | – | By request | Hagstofa Íslands | Statistics Iceland (2011) |
21 | Ireland 2000–10 | 318,184 | 248,016 | – | By request | CSO (Central Statistics Office) (2010) |
22 | Japan 2007–09 | 3,392,606 | – | Database | National Statistics Center (2010) | |
23 | Korea 2009 | 246,942 | 169,902 | – | Database | Statistics Korea (2010) |
24 | Lithuania 2010 | 42,120 | – | By request | Institute of Hygiene, Lithuania (2011) | |
25 | Malta 2001–10 | 31,294 | 25,050 | – | By request | Department of Health Information and Research, Malta (2011) |
26 | Netherlands 2003 | 141,936 | – | Paper | Cohen et al. (2008) | |
27 | New Zealand 2003–07 | 140,836 | 140,836 | – | By request | Ministry of Health (2011) |
28 | Norway 2009 | 41,342 | – | Database | Statistisk sentralbyrå | Statistics Norway (2010) | |
29 | Portugal (15+ years) 2008 | 98,840 | Aged over 15 years | Report | Machado et al. (2010) | |
30 | Scotland 2003 | 58,473 | – | Paper | Cohen et al. (2008) | |
31 | Serbia 2006–09 | 412,400 | – | Database | Statistical Office of the Republic of Serbia (2010) | |
32 | Slovenia 2005–09 | 92,647 | – | By request | Health Data Centre: National Institute of Public Health (2011) | |
33 | South Africa 2005 | 591,213 | – | Database | Statistics South Africa (2005) | |
34 | Spain (Andulasia) 2009 | 31,463 | – | Paper | Ruiz-Ramos et al. (2011) | |
35 | Sweden 2002 | 95,064 | – | Paper | Cohen et al. (2008) | |
36 | Switzerland (German) 2001 | 3,358 | Aged over 1 year | Paper | Fischer et al. (2004) | |
37 | Taiwan 2008 | 142,283 | – | Database | Taiwan (2008) | |
38 | USA 2003 | 2,452,154 | 1,806,070 | – | Database | CDC (Centre for Disease Control) (2006) |
39 | USA 2005 | 2,452,506 | 1,790,062 | – | Database | CDC (Centre for Disease Control) (2008) |
40 | Wales 2003 | 33,810 | – | Paper | Cohen et al. (2008) | |
41 | Canada (Manitoba) 2000 | – | 7,678 | Aged over 65 years | Paper | Menec et al. (2007) |
42 | Canada (Ontario) 2002 | – | 58,689 | Aged over 66 years | Paper | Motiwala et al. (2006) |
43 | Japan (Kyushu) 2000–04 | – | 50,857 | Aged over 65 years | Paper | Hashimoto et al. (2010) |
44 | Singapore 2006 | – | 10,399 | Aged over 65 years | Paper | Beng et al. (2009) |
45 | Wales 2001 | – | 27,532 | Aged over 65 years | Paper | Ahmad and O’Mahony (2005) |
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Broad, J.B., Gott, M., Kim, H. et al. Where do people die? An international comparison of the percentage of deaths occurring in hospital and residential aged care settings in 45 populations, using published and available statistics. Int J Public Health 58, 257–267 (2013). https://doi.org/10.1007/s00038-012-0394-5
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DOI: https://doi.org/10.1007/s00038-012-0394-5