Trends in Place of Death in a Super-Aged Society: A Population-Based Study, 1998–2017

Koyama, Toshihiro; Hagiya, Hideharu; Funahashi, Tomoko; Zamami, Yoshito; Yamagishi, Miyu; Onoue, Hitoshi; Teratani, Yusuke; Mikami, Naoko; Shinomiya, Kazuaki; Kitamura, Yoshihisa; Sendo, Toshiaki; Hinotsu, Shiro; Kano, Mitsunobu R.

doi:10.1089/jpm.2019.0445

Cited by 9 publications

(7 citation statements)

References 21 publications

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“…Third, lack of evaluation for and comparison with octogenarians or nonagenarians should be pointed out. However, compiled with the results of previous literature, 15,16 a similar tendency would be observed in such populations. Finally, death at home may include the centenarians who could enjoy a satisfactory EoLC by home medical care and on the other hand those who died alone and lonely.…”

Section: Discussionsupporting

confidence: 83%

“…However, we consider the point to pay attention to is the trend itself; in brief, more centenarians die in Japanese nursing homes. Although the present data did not include those of under the age of centenarians, such as octogenarians or nonagenarians, our recent study based on a population‐based observational analysis has revealed that the Japanese older population aged ≥65 years showed almost the same tendency 15 ; i.e., the APCs of nursing homes in the same period were 12.4% during 2006–2013 and 7.8% during 2013–2017, whereas the prevalence of hospital and home as PoD significantly decreased by 0.3% and 1.7%, respectively. Another study has revealed that the Japanese older patients with dementia have also followed a similar trend 16 ; the APCs of nursing homes in the same period were 6.5% during 2004–2011 and 3.3% during 2011–2016, while the prevalence of hospital and home as PoD significantly decreased by 2.5% (2005–2016) and 5.8% (1998–2016), respectively.…”

Section: Discussionmentioning

confidence: 91%

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Trends in places and causes of death among centenarians in Japan from 2006 to 2016

Koyama

Higashionna

Maruo

et al. 2022

Geriatrics Gerontology Int

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Aim Amid the global aging, an establishment of healthcare policies for the aged population is a common issue to be addressed. However, few studies on centenarians have reported place and cause of death (PoD and CoD, respectively) as indicators of end‐of‐life care quality. This study aimed to analyze trends in PoD and CoD among centenarians in Japan. Methods Data from death certificates from Japanese vital statistics were analyzed; 205 513 deaths occurred among centenarians (aged ≥100 years) in Japan during the period from 2006 to 2016. PoD prevalence was calculated for each CoD. Trends in PoD prevalence were analyzed using the Joinpoint regression model. Changing points, annual percentage changes, and average annual percentage changes (AAPCs) were calculated to examine trends. Results The number of deaths more than doubled from 10 340 in 2006 to 26 427 in 2016. PoDs were composed of hospitals (52.7%), nursing homes (31.4%), own homes (13.6%) and others (2.2%). Dementia and old age increased rapidly as CoD. Proportions of hospital and home deaths decreased, with AAPCs of −2.3% (95% confidence interval [CI], −2.6 to −1.9) and −2.3% (95% CI, −3.2 to −1.4), respectively. Conversely, the proportion of deaths in nursing homes rapidly increased, with an AAPC of 6.8% (95% CI, 6.0–7.7). Conclusions The results revealed changes in PoD among centenarians in Japan. Understanding these transitions is indispensable for health policy in aging societies. Geriatr Gerontol Int 2022; 22: 675–680.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 91%

Trends in places and causes of death among centenarians in Japan from 2006 to 2016

Koyama

Higashionna

Maruo

et al. 2022

Geriatrics Gerontology Int

Self Cite

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“…35 In Japan, which can be defined as the super-old society, hospital mortality ratios of individuals aged 65 and over has decreased after 2005. 36 According to our results, there is no change in place of death trends over the years in Turkey may be due to the sociocultural status of population, enhancement in hospital capacities due to the investments in the field of health, almost-all including reimbursement system, insufficient increase in nursing home capacity, trust in hospital care, and difficulty of providing home care.…”

Section: Discussionmentioning

confidence: 63%

Place of Death of Geriatric Population in Turkey: A 7-Year Observational Study

et al. 2021

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Background End-of-life care has become an important public health issue in recent years. Place of death is a major component of end-of-life care. Despite attempts to improve end-of-life care, there has not been published any data about place of deaths in Turkey. Aim: This retrospective, cross-sectional study investigates the place of death and trends over the years in geriatric age groups in Turkey. Methods: Patients who were admitted to geriatric outpatient clinic of a university hospital during a 7-year period were included. Place and date of death information were received from the death notification system and recorded as hospital or out-of-hospital death. Demographic and clinical data were collected from the hospital information system. Deaths occurring after March 1, 2020 were not included to eliminate the effect of coronavirus disease-2019 pandemic. Results: A total of 4025 (20.7%) patients were determined to be dead. Approximately three-quarters of deaths (73.0%) occurred in hospital. The number of deaths reported from nursing homes was only 13 (3.0%). Patients with dementia less frequently died in hospital, however, it was not statistically significant (12.4% vs 14.7%, P = .05). The prevalence of death in hospital was significantly higher in patients with chronic renal failure (3.1% vs 1.7%, P = .02). The presence of comorbid conditions such as heart failure, cerebrovascular disease, Parkinson's disease, chronic obstructive pulmonary disease/asthma, and cancer did not affect the place of death ( P = .24, .21, .24, .51, and .18). Out-of-hospital mortality increased with advanced age ( P < .001). No significant difference was found in the place of death over the years ( P = .41). Conclusion: To the best of our knowledge, this is the first study examining the place of death in Turkey, an aging country. Our results may help to establish policies about end-of-life care in elderly people to improve quality of life by using resources effectively.

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“…Although most people wish to spend their last moments at home, hospitals remain a common place of death in many countries [ 3 ]. Recent reports report that 76.2% of all deaths in South Korea [ 4 ], >80% of deaths in Japan [ 5 ], and 73% of deaths in Turkey [ 6 ] occurred in hospitals. Notably, this high number of hospital deaths in Korea has been attributed to the unavailability of competent palliative care services for the end of life outside hospitals [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Illnesses and Symptoms in Older Adults at the End of Life at Different Places of Death in Korea

Kim

2022

IJERPH

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Context: A comprehensive plan has been launched by the Korean government to expand hospice and palliative care from hospital-based inpatient units to other services, such as palliative care at home, palliative consultation, and palliative care at a nursing home. Objective: To examine the illnesses and symptoms at the end of life associated with the place of death among older Korean adults. Methods: This secondary data analysis included a stratified random sample of 281 adults identified from the exit survey of the Korean Longitudinal Study of Aging aged ≥65 years and who died in 2017–2018. Results: Overall, 69% of the patients died at hospitals, 13% died at long-term care facilities (LTCF), and 18% died at home. In the multinomial logistic regression analysis adjusting for age, sex, and marital status, older adults who died in the hospital had higher odds (2.02–4.43 times) of having limitations in activities of daily living (ADL) as well as symptoms of anorexia, depression, weakness, dyspnea, and periodic confusion 1 month before death than those who died at home. Older adults who died in an LTCF were more likely to have limitations in ADL and instrumental ADL as well as a higher likelihood (2–5 times) of experiencing pain, anorexia, fatigue, depression, weakness, dyspnea, incontinence, periodic confusion, and loss of consciousness than those who died at home. Conclusion: Since the majority of subjects died either in a hospital or an LCTF, and this proportion is expected to increase, policy planning should focus on improving the palliative case in these settings. Future policies and clinical practices should consider the illness and symptoms of older patients at the end of life across different care settings.

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Trends in Place of Death in a Super-Aged Society: A Population-Based Study, 1998–2017

Cited by 9 publications

References 21 publications

Trends in places and causes of death among centenarians in Japan from 2006 to 2016

Trends in places and causes of death among centenarians in Japan from 2006 to 2016

Place of Death of Geriatric Population in Turkey: A 7-Year Observational Study

Illnesses and Symptoms in Older Adults at the End of Life at Different Places of Death in Korea

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