Place of death in Europe: trends and associations in a 30-country panel (2005-2017)

Abstract

Background End-of-life care attracts major policy interest. Place of death is an important metric of individual experience and health system performance. Most people prefer to die at home, but hospital is the most common place of death in high-income countries. Little is known about international trends in place of death over time. Methods We aimed to collate population-level data on place of death in Europe for the years 2005-2017, and to evaluate association with national characteristics and policy choices. We sought outcome data from the 32 European Economic Area countries. We identified national economic, societal, demographic and health system predictors from Eurostat, OECD and the WHO. We analysed these cross-national panel data using linear regression with panel-corrected standard errors. Results Our analytic dataset included 30 countries accounting for over 95% of Europe's population and economic activity. Average national proportion of deaths occurring in hospital in the study period ranged from 26% to 68%, with a median of 52%. Trends vary markedly by region and wealth, with low and decreasing hospital deaths in the North-West, and high and increasing prevalence in the South and East. Controlling for demographic and economic factors, strong palliative care provision and generous government finance of long-term care were associated with fewer hospital deaths. Conclusions We found modifiable policy choices associated with hospital mortality, as well as wider structural economic and societal factors. Policymakers can act to curb worrisome trends in-hospital mortality. Data on places of death outside hospital can improve future research, policy and practice. Key messages Cross-national longitudinal analysis. Trends of hospital deaths in Europe, association between hospital mortality rate, palliative care and other healthcare factors.

Acompañamiento creativo para el duelo por muerte en contexto hospitalario: La experiencia en un Hospital en Bogotá

“…A nivel global el lugar de fallecimiento varía de acuerdo a cada país. Mientras en Europa la tendencia es a que estos ocurren con mayor frecuencia en contexto hospitalario (Jiang & May, 2021), en Estados Unidos la tendencia de los últimos años es a un aumento en que ocurran en el hogar (Cross & Warraich, 2019). En Colombia, la tendencia es a que la mayoría de las muertes ocurran en contexto hospitalario.…”