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Predictors associated with the place of death in a country with increasing hospital deaths

Quality of Cancer Care Branch, Cancer Prevention and Early Detection Branch, Cancer Information Branch Research Institute and Hospital, National Cancer Center, Goyang, lawyun08{at}ncc.re.kr

Min Kyoung Lim

Quality of Cancer Care Branch, Cancer Prevention and Early Detection Branch, Cancer Information Branch Research Institute and Hospital, National Cancer Center, Goyang

Kui-Son Choi

Quality of Cancer Care Branch, Cancer Prevention and Early Detection Branch, Cancer Information Branch Research Institute and Hospital, National Cancer Center, Goyang

Young Sun Rhee

Quality of Cancer Care Branch, Cancer Prevention and Early Detection Branch, Cancer Information Branch Research Institute and Hospital, National Cancer Center, Goyang

Objectives: To evaluate the contribution of type of illness, socio-demographic factors, and area of residence to the place of death in a country with increasing hospital deaths. Design: Descriptive study of hospital deaths using a 10-year death registration database from the Korean National Statistical Office. Setting and participants: Through the National Vital Statistics System, 2 402 259 deaths were registered in Korea from 1992 to 2001. Measurement and main results: There was a significant trend toward an increase in the proportion of hospital deaths, from 16.6% in 1992 to 39.9% in 2001. The proportion of deaths at home decreased over that period, from 72.9 to 49.2%. The risk of hospital death versus home death was lower for those aged 75 years and over (adjusted odds ratio: 0.212; 95% confidence interval: 0.210-0.214) compared with those B ^/ 55 years, and for people who were highly educated (2.04; 2.02-2.06), had white-collar jobs (1.55; 1.54-1.57), and resided in areas with more available hospital beds (2.46; 2.42-2.51). Compared with other causes of death, the risk of dying in hospital was higher for patients with ischaemic heart disease (1.83; 1.79-1.86), cancer (1.25; 1.23-1.26) and chronic lower respiratory disease (1.21; 1.18-1.23). Conclusions: Trends in place of death are influenced by available hospital beds, socio-demographic factors and the nature of the terminal disease, in a country with increasing hospital deaths. These associations should be viewed within the context of culture and local health care systems.

Key Words: place of death • predictor • trend

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