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[Where does the terminal patient die?]
A Jimeno Aranda1, R Catalán, M García Ruiz
1Centro de Salud Delicias Sur, Zaragoza.
Objective:
To determine whether patients terminally ill with gastric cancer die in hospital or at home and what the conditioning factors are.
Design:
Descriptive, crossover and retrospective study. SITE. A province-wide study in Zaragoza province.
Patients:
The sample consisted of 606 patients in Zaragoza province who had been diagnosed, between 1980 and 1989, as suffering gastric cancer and who later died of this condition.
Measurements And Main Results:
The follow-up rate of the patients' evolution was 96%. Of these, 50.2% died in hospital and 46.2% at home. Average age was 67 +/- 10 years. 62% were men; 38% women. Average time of survival was 6 months. None of these factors nor the existence or otherwise of surgery affected the place of death. What was notable was that 42% of patients in urban areas died at home; whereas 66% did so in rural areas (p < 0.0001).
Conclusions:
Patients terminally ill with gastric cancer in Zaragoza province are just as likely to die at home as in hospital. In rural areas people are significantly more likely to die in their own homes. We believe these findings demonstrate the need to develop Primary Care programmes to alleviate terminal suffering.