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Anales del Sistema Sanitario de Navarra
versión impresa ISSN 1137-6627
Resumen
CABANERO-MARTINEZ, M.J. et al. Place of death of people with conditions needing palliative care in the different autonomous communities (regions) of Spain. Anales Sis San Navarra [online]. 2020, vol.43, n.1, pp.69-80. Epub 17-Ago-2020. ISSN 1137-6627. https://dx.doi.org/10.23938/assn.0856.
Background
Dying at home is the most frequent preference, with the institutionalized context being the most common place of death. To determine the place of death in conditions requiring palliative care of residents in Spain aged 15 or over by Autonomous Community (AC) and to examine the relationship with oncological vs. non-oncological causes of death.
Methods
Population-based cross-sectional study analysing medical death certificates. Adjusted effects of socio-demographic variables, AC and causes on the place of death were estimated calculating odds of death in hospital vs. at home (OH/H) and in a nursing home vs. at home (ON/H), and odds ratio (ORH/H and ORN/H) by multinomial logistic regression models.
Results
During 2012-2015, 1,611,767 deaths were recorded, 64.8% corresponding to the target population. Death in hospital was 77% more frequent than death at home, while death in a nursing home was 53% lower. Male sex, lower age, lower academic level, place of birth other than Spain, bigger city size and civil status other than married displayed a relationship with death in hospital, while the same variables except female sex and higher age did so in a nursing home. Adjusted OH/H > 1 and ON/H < 1 were observed in all AC, except Catalonia. Oncological causes made OH/H < 1 in almost 50% of AC, while ON/H continue to be < 1.
Conclusions
Most deaths were in hospital and fewer at nursing homes, despite oncological causes increasing deaths at home (adjusted effect).
Palabras clave : Place of death; Mortality; Palliative care; Death certificate; Epidemiology.