Place of death related to demographic factors for hospice patients in Wellington, Aotearoa New Zealand

Abstract

Age, economics, diagnosis, ethnicity, marital status, and whether one enters a hospice service for (at least in part) respite were all associated to a certain extent with where one dies. These findings contribute to the growing evidence linking various factors, especially ethnic groups, with place of death.

Association of Hospice Patients' Income and Care Level With Place of Death

“…4,30 Although hospice provides substantial resources, the majority of direct caregiving is provided by family and friends, with hospice support provided only intermittently and for short periods. During the last year of life, more than 2/3 of patients require informal caregiving assistance.…”

Policy for home or hospice as the preferred place of death from cancer: Scottish Health and Ethnicity Linkage Study population cohort shows challenges across all ethnic groups in Scotland

“…We conclude that cancer deaths occur most often in hospital, home and hospice in that order for all Scotland; differences in place of death by ethnic group found in England6 7 and internationally8 9 10 are limited in Scotland, in part reflecting very small ethnic populations, but also perhaps implying more equitable access to palliative care services regardless of ethnicity. However, regardless of socioeconomic indicator used, more affluent Scottish White patients were less likely to die in hospital; existing socioeconomic indicators detected no clear trend for the non-White population.…”

“…In New Zealand, Asians aged 65 years or younger with cancer and admitted initially to hospice for respite care were more likely to die in a hospice setting 9. In California, a multilevel study established for US-born Asians and Hispanics, age, marital status, nursing home residence and distance to a hospital explained differences in place of death compared with the White population while for African-Americans, availability of hospital beds accounted for most of the difference 10…”

Settings of Care Within Hospice

“…7,11–15 Predictors of place of death include both macro- (e.g., population demographics, regional and cultural differences) and micro-level (e.g., individual, disease specific) characteristics. Macro-level factors associated with death at home include living in a rural area 12 or in a county with low proportions of racial/ethnic minorities.…”