Where Do People Die in Sweden? A Population-based Study of the Distribution and Determinants of Place of Death

• Background: Place of death, with home reported to be the most desirable place, is considered to be one important aspect of quality of care at the end of life. Sweden, until now, lacks population-based studies that not only examine place of death, but also what factors that may influence where people die. Objectives: The objectives were to examine place of death in Sweden and associations between place of death and diagnosis, personal characteristics, geographical and socioeconomic factors. Design and methods: This study, being part of the International Place of Death (IPoD) project, was based on all deaths in Sweden 2012 (n = 91874). Data was derived from death certificates and population-based registers. Distribution of place of death and other variables were analysed descriptively. Binary logistic regressions were performed to examine factors associated with dying in hospital, at home and in nursing homes. Results: Of all deaths in 2012, 42.1 % died in hospital, 17.8 % at home and 38.1 % in nursing homes. Being married and having higher education increased the likelihood of dying at home, whereas living in an urban area decreased the likelihood of dying at home. Being old, and dying from Dementia increased the likelihood of dying in nursing home. In fact, the majority of individuals >90 years (61.9 %), and with dementia (89.8 %) died in nursing home, while most (74.5 %) children 0–17 years died in hospital. Discussion and conclusions: In Sweden, people likely to be in need of palliative care continue to die in hospitals, and many old individuals die in nursing homes. While dying in hospital has been associated with risk of futile treatment, previous studies also report lack of palliative approaches in nursing homes. The geographical and socioeconomic differences in place of death call for further attention. As the Swedish national guidelines for palliative care were launched in 2012, these results provide important baseline information to evaluate its effects.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)

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