Factors Determining Home Death Among Older Adults in Thailand

BackgroundPalliative care services are expanding in Thailand, where dying at home is a key goal and a preference for older adults. However, limited research explores the factors influencing home deaths in this population. This study was the first to identify predictors of home deaths among older adults in Thailand.MethodsWe conducted a secondary data analysis of the Health Aging and Retirement in Thailand (HART) study, encompassing 320 participants. Descriptive statistics, chi-square tests, and Mann-Whitney U tests were used to compare differences in the place of death. Logistic regression was conducted to examine the likelihood of home deaths.ResultsA total of 65.6% of decedents died at home, with an increasing trend in home deaths observed from 65% in 2017 to 70% in 2022. Significant differences were found between home deaths and non-home deaths regarding age at death, marital status, employment status, cause of death, and geographic region. Older adults residing in the North and Northeast regions were more likely to die at home compared to those in Bangkok and its vicinity. Deaths attributed to natural aging were strongly associated with a higher likelihood of home deaths, whereas deaths caused by infectious diseases were less likely to occur at home.ConclusionSocial, environmental, and health-related factors significantly influence home deaths among older adults in Thailand. The health care system should prioritize community-based palliative care services to address the disparities in place of death and support vulnerable populations in achieving their preferred end-of-life outcomes.