Changes in place of death in Sweden 2004-2011 : a study of urban elderly receiving public eldercare services
Spethman, Amanda (2014)
2014
International Health, HES
Terveystieteiden yksikkö - School of Health Sciences
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Hyväksymispäivämäärä
2014-02-25
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:uta-201403281284
https://urn.fi/URN:NBN:fi:uta-201403281284
Tiivistelmä
Background: Most people prefer to die at their place of residence, yet appropriate end-of-life care is not always available there. This lack of access to care is of particular concern in the context of Swedish eldercare, where the supply of publically financed services at all levels have been cut significantly in recent years.
Aims: The aim of this study is to investigate whether the distribution of places of death has changed in recent years, and discuss how this might have been affected by changes in the public eldercare system during the same period.
Data: The data come from a longitudinal study of recipients of public eldercare in one district of Stockholm. The sample includes all deaths in the study from March 2004 through February 2012, for which the date of death and place of death were recorded.
Methods and Results: Descriptive analysis showed significant changes in the distribution of places of death from 2004 through 2011: hospital deaths decreased from 20% to 12%, nursing home deaths decreased from 70% to 57%, and home deaths increased from 10% to 32%. Logistic regression analysis showed that, after adjusting for age, sex, and place of residence, year of death was negatively associated with hospital death. Stratified analysis based on place of residence revealed that the bulk of this effect of time emerged from the subgroup of individuals residing in private homes prior to death. Those living in other types of residence showed no significant changes in place of death over time.
Conclusions: Dying in private homes is a growing trend among elderly persons, which warrants careful planning and regulating to ensure that these individuals receive timely, good quality end-of-life care, and that this care is equally accessible to all. In addition, the finding that those who live in nursing homes almost always die there highlights the need for guaranteed availability of palliative care services in these settings.
Aims: The aim of this study is to investigate whether the distribution of places of death has changed in recent years, and discuss how this might have been affected by changes in the public eldercare system during the same period.
Data: The data come from a longitudinal study of recipients of public eldercare in one district of Stockholm. The sample includes all deaths in the study from March 2004 through February 2012, for which the date of death and place of death were recorded.
Methods and Results: Descriptive analysis showed significant changes in the distribution of places of death from 2004 through 2011: hospital deaths decreased from 20% to 12%, nursing home deaths decreased from 70% to 57%, and home deaths increased from 10% to 32%. Logistic regression analysis showed that, after adjusting for age, sex, and place of residence, year of death was negatively associated with hospital death. Stratified analysis based on place of residence revealed that the bulk of this effect of time emerged from the subgroup of individuals residing in private homes prior to death. Those living in other types of residence showed no significant changes in place of death over time.
Conclusions: Dying in private homes is a growing trend among elderly persons, which warrants careful planning and regulating to ensure that these individuals receive timely, good quality end-of-life care, and that this care is equally accessible to all. In addition, the finding that those who live in nursing homes almost always die there highlights the need for guaranteed availability of palliative care services in these settings.