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International study of the place of death of people with cancer: a population-level comparison of 14 countries across 4 continents using death certificate data

International study of the place of death of people with cancer: a population-level comparison of 14 countries across 4 continents using death certificate data
International study of the place of death of people with cancer: a population-level comparison of 14 countries across 4 continents using death certificate data
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.
cancer, place of death, death certificates, end-of-life care, cross-national comparison
0007-0920
1397-1404
Cohen, J.
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Pivodic, L.
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Miccinesi, G.
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Onwuteaka-Philipsen, B.D.
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Naylor, W.A.
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Wilson, D.M.
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Loucka, M.
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Csikos, A.
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Pardon, K.
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Van den Block, L.
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Ruiz-Ramos, M.
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Cardenas-Turanzas, M.
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Rhee, Y.
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Aubry, R.
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Hunt, K.
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Teno, J.
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Houttekier, D.
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Deliens, L.
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Cohen, J.
6eddab3c-5a4d-458d-bcf9-c03812e057ea
Pivodic, L.
8a4e6b5f-d213-42f5-b8e0-b5a94bd95292
Miccinesi, G.
36cbb6b3-04e1-41e5-a3fb-065f633f31e6
Onwuteaka-Philipsen, B.D.
ea485b7c-fd84-426e-8f46-ceb4e48c8b29
Naylor, W.A.
db8f51c0-7477-456b-be97-9c47efb5f9f3
Wilson, D.M.
eb00022d-1be0-4361-8252-ab5666ad36ef
Loucka, M.
398e9db5-8be1-43aa-be0f-f46cb82c137d
Csikos, A.
05ec5f86-eacb-47c2-ab01-88353dc2bb01
Pardon, K.
8db2d5ff-95dd-4e2c-ad9c-a3913d55a137
Van den Block, L.
f6691beb-953d-4ed3-873b-4dfc2c912525
Ruiz-Ramos, M.
885c9cf2-4582-411c-98c0-1a4849fbce3b
Cardenas-Turanzas, M.
1627b2f6-ee6c-4748-9513-c85c4bd31c03
Rhee, Y.
14fdbdc8-48ed-4bb1-89f0-8724cd040f0e
Aubry, R.
600aed99-6d61-419d-9f30-d153fe547a13
Hunt, K.
5eab8123-1157-4d4e-a7d9-5fd817218c6e
Teno, J.
02f45079-a69e-4dde-8d88-43bf8d4ef711
Houttekier, D.
b0f0d90c-ab09-4079-80ca-efc2f445be3f
Deliens, L.
5a6d963a-bb44-4291-97c6-fd78dafa51d4

Cohen, J., Pivodic, L., Miccinesi, G., Onwuteaka-Philipsen, B.D., Naylor, W.A., Wilson, D.M., Loucka, M., Csikos, A., Pardon, K., Van den Block, L., Ruiz-Ramos, M., Cardenas-Turanzas, M., Rhee, Y., Aubry, R., Hunt, K., Teno, J., Houttekier, D. and Deliens, L. (2015) International study of the place of death of people with cancer: a population-level comparison of 14 countries across 4 continents using death certificate data. British Journal of Cancer, 113 (9), 1397-1404. (doi:10.1038/bjc.2015.312). (PMID:26325102)

Record type: Article

Abstract

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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Accepted/In Press date: 10 August 2015
e-pub ahead of print date: 1 September 2015
Published date: 3 November 2015
Keywords: cancer, place of death, death certificates, end-of-life care, cross-national comparison
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 388220
URI: http://eprints.soton.ac.uk/id/eprint/388220
ISSN: 0007-0920
PURE UUID: 1275eb6d-5836-4dbf-bee7-1339b07d7673
ORCID for K. Hunt: ORCID iD orcid.org/0000-0002-6173-7319

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Date deposited: 22 Feb 2016 11:49
Last modified: 15 Sep 2021 01:56

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Contributors

Author: J. Cohen
Author: L. Pivodic
Author: G. Miccinesi
Author: B.D. Onwuteaka-Philipsen
Author: W.A. Naylor
Author: D.M. Wilson
Author: M. Loucka
Author: A. Csikos
Author: K. Pardon
Author: L. Van den Block
Author: M. Ruiz-Ramos
Author: M. Cardenas-Turanzas
Author: Y. Rhee
Author: R. Aubry
Author: K. Hunt ORCID iD
Author: J. Teno
Author: D. Houttekier
Author: L. Deliens

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