期刊
BRITISH JOURNAL OF CANCER
卷 113, 期 9, 页码 1397-1404出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/bjc.2015.312
关键词
cancer; place of death; death certificates; end-of-life care; cross-national comparison
类别
资金
- Research Foundation Flanders
- Willy Gepts Fund (Wetenschappelijk Fonds Willy Gepts)
Background: Where people die can influence a number of indicators of the quality of dying. We aimed to describe the place of death of people with cancer and its associations with clinical, socio-demographic and healthcare supply characteristics in 14 countries. Methods: Cross-sectional study using death certificate data for all deaths from cancer (ICD-10 codes C00-C97) in 2008 in Belgium, Canada, Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (2010), USA (2007) and Wales (N = 1 355 910). Multivariable logistic regression analyses evaluated factors associated with home death within countries and differences across countries. Results: Between 12% (South Korea) and 57% (Mexico) of cancer deaths occurred at home; between 26% (Netherlands, New Zealand) and 87% (South Korea) occurred in hospital. The large between-country differences in home or hospital deaths were partly explained by differences in availability of hospital-and long-term care beds and general practitioners. Haematologic rather than solid cancer (odds ratios (ORs) 1.29-3.17) and being married rather than divorced (ORs 1.17-2.54) were most consistently associated with home death across countries. Conclusions: A large country variation in the place of death can partly be explained by countries' healthcare resources. Country-specific choices regarding the organisation of end-of-life cancer care likely explain an additional part. These findings indicate the further challenge to evaluate how different specific policies can influence place of death patterns.
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