The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Inequality in place-of-death among children: a Danish nationwide study

Inequality in place-of-death among children: a Danish nationwide study
Inequality in place-of-death among children: a Danish nationwide study

To identify predictors for home death among children using socio-demographic factors and cause of death. It is a nationwide registry study. A cohort of children (1–17 years) who died between 1 January 2006 and 31 December 2016. It was set in Denmark, Europe. Predictors for home death were assessed: age, gender, diagnosis, region of residence, urbanicity, household income and immigrant status. Of 938 deceased children included, causes of death were solid tumours (17.3%), haematological cancers (8.5%) and non-cancerous conditions (74.2%). A total of 25% died at home. Compared to the lowest quartile, the groups with higher household income did not have a higher probability of dying at home (adjusted odds ratio (adj-OR) 0.8 (95% CI 0.5–1.2/1.3)). Dying of haematological cancers (adj-OR 0.3 (95% CI 0.2–0.7)) and non-cancerous conditions (adj-OR 0.5 (95% CI 0.3–0.7)) was associated with lower odds for home death compared to dying of solid tumours. However, being an immigrant was negatively associated with home death (adj-OR 0.6 (95% CI 0.4–0.9)). Moreover, a tendency was also found that being older, male, living outside the capital and in more urban areas were notable in relation to home death, however, not statistically significant. Conclusions: The fact that household income was not associated with dying at home may be explained by the Danish tax-financed healthcare system. However, having haematological cancers, non-cancerous conditions or being an immigrant were associated with lower odds for home death. Cultural differences along with heterogeneous trajectories may partly explain these differences, which should be considered prospectively.What is Known:• Prior studies have shown disparities in place-of-death of terminally ill children with diagnosis, ethnicity and socio-economic position as key factors.• Danish healthcare is tax-financed and in principle access to healthcare is equal; however, disparities have been found in the intensity of treatment of terminally ill children.What is New:• In a tax-financed, equal-access healthcare system, children died just as frequently at home in families with low as high household income.• Disparities in home death were related to diagnosis and immigrant status.

Child, Denmark, End-of-life, Paediatrics, Place-of-death, Youth
0340-6199
Wolff, Sanne Lausen
24c702e4-859e-485e-b133-2d8d0dfc5fe2
Christiansen, Christian Fynbo
e771a30d-0109-41fd-935d-3167d0d57b3c
Johnsen, Søren Paaske
bd53071f-4ae7-4d7c-bec8-eb77e699f188
Schroeder, Henrik
dce3dd73-abe8-454b-9de1-7a1d9c9e8751
Darlington, Anne-sophie
472fcfc9-160b-4344-8113-8dd8760ff962
Jespersen, Bodil Abild
5f214924-bf14-48dc-a656-4be0518f9351
Olsen, Marianne
3c47719b-840e-4e1c-8876-f3dcdc90d949
Neergaard, Mette Asbjoern
6c5fb970-9b20-4e56-a913-333362a9e66c
Wolff, Sanne Lausen
24c702e4-859e-485e-b133-2d8d0dfc5fe2
Christiansen, Christian Fynbo
e771a30d-0109-41fd-935d-3167d0d57b3c
Johnsen, Søren Paaske
bd53071f-4ae7-4d7c-bec8-eb77e699f188
Schroeder, Henrik
dce3dd73-abe8-454b-9de1-7a1d9c9e8751
Darlington, Anne-sophie
472fcfc9-160b-4344-8113-8dd8760ff962
Jespersen, Bodil Abild
5f214924-bf14-48dc-a656-4be0518f9351
Olsen, Marianne
3c47719b-840e-4e1c-8876-f3dcdc90d949
Neergaard, Mette Asbjoern
6c5fb970-9b20-4e56-a913-333362a9e66c

Wolff, Sanne Lausen, Christiansen, Christian Fynbo, Johnsen, Søren Paaske, Schroeder, Henrik, Darlington, Anne-sophie, Jespersen, Bodil Abild, Olsen, Marianne and Neergaard, Mette Asbjoern (2021) Inequality in place-of-death among children: a Danish nationwide study. European Journal of Pediatrics. (doi:10.1007/s00431-021-04250-5).

Record type: Article

Abstract

To identify predictors for home death among children using socio-demographic factors and cause of death. It is a nationwide registry study. A cohort of children (1–17 years) who died between 1 January 2006 and 31 December 2016. It was set in Denmark, Europe. Predictors for home death were assessed: age, gender, diagnosis, region of residence, urbanicity, household income and immigrant status. Of 938 deceased children included, causes of death were solid tumours (17.3%), haematological cancers (8.5%) and non-cancerous conditions (74.2%). A total of 25% died at home. Compared to the lowest quartile, the groups with higher household income did not have a higher probability of dying at home (adjusted odds ratio (adj-OR) 0.8 (95% CI 0.5–1.2/1.3)). Dying of haematological cancers (adj-OR 0.3 (95% CI 0.2–0.7)) and non-cancerous conditions (adj-OR 0.5 (95% CI 0.3–0.7)) was associated with lower odds for home death compared to dying of solid tumours. However, being an immigrant was negatively associated with home death (adj-OR 0.6 (95% CI 0.4–0.9)). Moreover, a tendency was also found that being older, male, living outside the capital and in more urban areas were notable in relation to home death, however, not statistically significant. Conclusions: The fact that household income was not associated with dying at home may be explained by the Danish tax-financed healthcare system. However, having haematological cancers, non-cancerous conditions or being an immigrant were associated with lower odds for home death. Cultural differences along with heterogeneous trajectories may partly explain these differences, which should be considered prospectively.What is Known:• Prior studies have shown disparities in place-of-death of terminally ill children with diagnosis, ethnicity and socio-economic position as key factors.• Danish healthcare is tax-financed and in principle access to healthcare is equal; however, disparities have been found in the intensity of treatment of terminally ill children.What is New:• In a tax-financed, equal-access healthcare system, children died just as frequently at home in families with low as high household income.• Disparities in home death were related to diagnosis and immigrant status.

Text
Inequality in place-of-death among children a Danish nationwide study - Accepted Manuscript
Restricted to Repository staff only until 4 September 2022.
Request a copy

More information

Accepted/In Press date: 30 August 2021
e-pub ahead of print date: 4 September 2021
Additional Information: Funding Information: This study was supported by grants from M.L. Jørgensen and Gunnar Hansens Fond, Dagmar Marshalls Fond and Kong Christian den Tiendes Fond. The funders had no role in study design, data collection and analyses, decision to publish or construction of the manuscript. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: Child, Denmark, End-of-life, Paediatrics, Place-of-death, Youth

Identifiers

Local EPrints ID: 451343
URI: http://eprints.soton.ac.uk/id/eprint/451343
ISSN: 0340-6199
PURE UUID: f57dddbb-f33d-422c-b97f-04debebb9025

Catalogue record

Date deposited: 21 Sep 2021 16:32
Last modified: 25 Nov 2021 21:43

Export record

Altmetrics

Contributors

Author: Sanne Lausen Wolff
Author: Christian Fynbo Christiansen
Author: Søren Paaske Johnsen
Author: Henrik Schroeder
Author: Bodil Abild Jespersen
Author: Marianne Olsen
Author: Mette Asbjoern Neergaard

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×