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Where Patients With Cancer Die: A Population-Based Study, 1990 to 2012
Roger W Hunt1,2, Katina D'Onise3, Anh-Minh Thi Nguyen4
1Central Adelaide Palliative Care Service, South Australia, Australia.
Journal of Palliative Care
|November 29, 2018
Summary
Cancer deaths are increasingly occurring in nursing homes, not at home, impacting end-of-life care. This trend highlights disparities and the need for improved palliative care in aged care facilities.
Area of Science:
- Oncology
- Palliative Care
- Health Services Research
Background:
- The place of death for cancer patients has shifted significantly over two decades.
- Understanding these trends is crucial for optimizing end-of-life care delivery.
- Patient preferences and socioeconomic factors influence where cancer patients die.
Purpose of the Study:
- To analyze trends in the place of death for cancer patients between 1990 and 2012.
- To identify key factors associated with different places of death.
- To highlight challenges in current end-of-life cancer care.
Main Methods:
- A population-based descriptive study utilizing South Australian Cancer Registry data.
- Analysis of 86,257 cancer patient deaths from 1990 to 2012.
- Multivariate analyses to identify predictors of place of death.
Main Results:
- Cancer deaths in hospitals decreased from 63.4% to 50.9%, while nursing home deaths rose from 8.2% to 22.5%.
- Deaths in hospices and at home remained below 15% after 2000.
- Younger patients, higher socioeconomic status, and shorter survival times were associated with specific places of death.
Conclusions:
- The proportion of cancer deaths at home is low compared to international standards, suggesting unmet patient preferences.
- The increasing trend of deaths in nursing homes raises concerns about the capacity of these facilities to provide adequate palliative care.
- Future models of palliative care must address patient preferences, the rise of nursing home deaths, and health inequities.
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