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Deaths of children occurring at home in six European countries

G Pousset1, J Bilsen, J Cohen

  • 1Bioethics Institute Ghent, Ghent University, Ghent, Belgium. geert.pousset@ugent.be

Child: Care, Health and Development
|December 8, 2009
PubMed

Insights

Home deaths for children with complex chronic conditions (CCC) vary significantly across Europe. Facilitating end-of-life care at home requires further improvements, especially for cancer patients.

Area of Science:

  • Pediatric Palliative Care
  • Public Health
  • Epidemiology

Background:

  • Limited population-based European data exists on children's place of death.
  • Understanding home death rates is crucial for end-of-life care planning.

Purpose of the Study:

  • Compare home death proportions for all children and those with complex chronic conditions (CCC) in six European countries.
  • Investigate socio-demographic and clinical factors influencing place of death.

Main Methods:

  • Analysis of death certificates for children aged 1-17 years in Belgium, Netherlands, Norway, England, Wales (2003), and Italy (2002).
  • Inclusion of gender, cause, place of death, socio-economic status, urbanization, and hospital bed availability.
  • Utilized frequencies and multivariate logistic regression for data analysis.

Main Results:

  • 3328 deaths analyzed; 31.2% involved CCC.
  • Home death proportion ranged from 19.6% (Italy) to 28.6% (Netherlands).
  • Home deaths were higher for CCC cases (21.7%-50%) and more likely for older children (over 10) and cancer patients, with significant cross-country variations persisting after adjustments.

Conclusions:

  • Home deaths represent a significant portion of deaths for children with CCCs.
  • Variations across disease categories and countries highlight potential for improved home-based end-of-life care.
  • Facilitating home deaths aligns with family preferences and requires further development in care provision.
Abstract

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