Urbanization and place of death for the elderly: a 10-year population-based study

Lin, Herng Ching; Lin, Yen Ju; Liu, Tsai Ching; Chen, Chin Shyan

doi:10.1177/0269216307083033

Cited by 23 publications

(27 citation statements)

References 25 publications

(46 reference statements)

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“…The 359 communities in Taiwan were classified into 7groups: highly urbanized area, moderately urbanized area, boomtown, general town, aging town, agricultural town, and remote town. This classification method has been used in several studies [48]–[50].…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Dementia in Patients Exposed to Nitrogen Dioxide and Carbon Monoxide: A Population-Based Retrospective Cohort Study

et al. 2014

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BackgroundThe air pollution caused by vehicular emissions is associated with cognitive decline. However, the associations between the levels of nitrogen dioxide (NO2) and carbon monoxide (CO) exposure and dementia remain poorly defined and have been addressed in only a few previous studies.Materials and MethodsIn this study, we obtained data on 29547 people from the National Health Insurance Research Database (NHIRD) of Taiwan, including data on 1720 patients diagnosed with dementia between 2000 and 2010, and we evaluated the risk of dementia among four levels of air pollutant. Detailed data on daily air pollution were available from January 1, 1998 to December 31, 2010. Yearly average concentrations of pollutants were calculated from the baseline to the date of dementia occurrence, withdrawal of patients, or the end of the study, and these data were categorized into quartiles, with Q1 being the lowest level and Q4 being the highest.ResultsIn the case of NO2, the adjusted hazard ratios (HRs) of dementia for all participants in Q2, Q3, and Q4 compared to Q1 were 1.10 (95% confidence interval (CI), 0.96–1.26), 1.01 (95% CI, 0.87–1.17), and 1.54 (95% CI, 1.34–1.77), and in the case of CO, the adjusted HRs were 1.07 (95% CI, 0.92–1.25), 1.37 (95% CI, 1.19–1.58), and 1.61 (95% CI, 1.39–1.85).ConclusionThe results of this large retrospective, population-based study indicate that exposure to NO2 and CO is associated with an increased risk of dementia in the Taiwanese population.

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Section: Discussionmentioning

confidence: 99%

Increased Risk of Dementia in Patients Exposed to Nitrogen Dioxide and Carbon Monoxide: A Population-Based Retrospective Cohort Study

et al. 2014

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“…12 With regard to the area of residence, few studies have analyzed the influence that it has on the place of death. 13 However, these studies have shown that the level of urbanization influences the place of death, with hospital deaths being associated with a better level of urbanization. Our result of death in home for people living in rural areas is consistent and could be explained by the fact that in rural areas there is a lack of health care services.…”

Section: Discussionmentioning

confidence: 99%

Home Versus Hospital Mortality From Cancer in México (1999-2009)

Castillo-Guzmán

Palacios-Ríos

Nava-Obregón

et al. 2012

Am J Hosp Palliat Care

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“…This variable also controls for regional differences in palliative care and chaplaincy services [37-39]. Population density was included as a control variable in the analyses because it also has been found to be related to the rate of hospital deaths [17,18,22]. The AHA survey measures population density on a 0-6 scale, reflecting the size of the Metropolitan Statistical Area in which a hospital is located.…”

Section: Methodsmentioning

confidence: 99%

“…Research in Belgium [10], Germany [17], and Taiwan [18] has shown that people living in urban areas are more likely to die in the hospital than those living in rural areas, although findings from other studies are inconsistent [2,7]. The observed relationship between hospital deaths and population density, as well as the regional differences, may be partly attributable to the number of available hospital beds per capita, with areas that have a greater number of hospital beds per person having higher rates of hospital deaths [3,19].…”

Section: Introductionmentioning

confidence: 99%

A national study of chaplaincy services and end-of-life outcomes

et al. 2012

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BackgroundMedicine has long acknowledged the role of chaplains in healthcare, but there is little research on the relationship between chaplaincy care and health outcomes. The present study examines the association between chaplaincy services and end-of-life care service choices.MethodsHealthCare Chaplaincy purchased the AHA survey database from the American Hospital Association. The Dartmouth Atlas of Health Care database was provided to HealthCare Chaplaincy by The Dartmouth Institute for Health Policy & Clinical Practice, with the permission of Dartmouth Atlas Co-Principal Investigator Elliot S. Fisher, M.D., M.P.H. The Dartmouth Atlas of Health Care is available interactively on-line at http://www.dartmouthatlas.org/. Patient data are aggregated at the hospital level in the Dartmouth Atlas of Health Care. IRB approval was not sought for the project because the data are available to the public through one means or another, and neither database contains data about individual patients, i.e. all the variables are measures of hospital characteristics. We combined and analyzed data from the American Hospital Association’s Annual Survey and outcome data from The Dartmouth Atlas of Health Care in a cross-sectional study of 3,585 hospitals. Two outcomes were examined: the percent of patients who (1) died in the hospital, and (2) were enrolled in hospice. Ordinary least squares regression was used to measure the association between the provision of chaplaincy services and each of the outcomes, controlling for six factors associated with hospital death rates.Results and discussionThe analyses found significantly lower rates of hospital deaths (β = .04, p < .05) and higher rates of hospice enrollment (β = .06, p < .001) for patients cared for in hospitals that provided chaplaincy services compared to hospitals that did not.ConclusionsThe findings suggest that chaplaincy services may play a role in increasing hospice enrollment. This may be attributable to chaplains’ assistance to patients and families in making decisions about care at the end-of-life, perhaps by aligning their values and wishes with actual treatment plans. Additional research is warranted.

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Urbanization and place of death for the elderly: a 10-year population-based study

Abstract: After adjusting for other socio-demographic, clinical and healthcare factors, the place of death has a significant association with the level of urbanization among the elderly.

Cited by 23 publications

References 25 publications

Increased Risk of Dementia in Patients Exposed to Nitrogen Dioxide and Carbon Monoxide: A Population-Based Retrospective Cohort Study

Increased Risk of Dementia in Patients Exposed to Nitrogen Dioxide and Carbon Monoxide: A Population-Based Retrospective Cohort Study

Home Versus Hospital Mortality From Cancer in México (1999-2009)

A national study of chaplaincy services and end-of-life outcomes

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