Wilson Donna M, Truman Corrine D, Thomas Roger, Fainsinger Robin, Kovacs-Burns Kathy, Froggatt Katherine, Justice Christopher
Faculty of Nursing, Third Floor Clinical Sciences Building, University of Alberta, Edmonton, Alberta, Canada T6T 1E8.
Soc Sci Med. 2009 May;68(10):1752-8. doi: 10.1016/j.socscimed.2009.03.006. Epub 2009 Apr 1.
This 2008 study assessed location-of-death changes in Canada during 1994-2004, after previous research had identified a continuing increase to 1994 in hospital deaths. The most recent (1994-2004) complete population and individual-level Statistics Canada mortality data were analyzed, involving 1,806,318 decedents of all Canadian provinces and territories except Quebec. A substantial and continuing decline in hospitalized deaths was found (77.7%-60.6%). This decline was universal among decedents regardless of age, gender, marital status, whether they were born in Canada or not, across urban and rural provinces, and for all but two (infrequent) causes of death. This shift occurred in the absence of policy or purposive healthcare planning to shift death or dying out of hospital. In the developed world, recent changing patterns in the place of death, as well as the location and type of care provided near death appear to be occurring, making location-of-death trends an important topic of investigation. Canada is an important case study for highlighting the significance of location-of-death trends, and suggesting important underlying causal relationships and implications for end-of-life policies and practices.
这项2008年的研究评估了1994年至2004年期间加拿大的死亡地点变化情况，此前的研究已确定到1994年医院死亡人数持续增加。分析了加拿大统计局最新的（1994年至2004年）完整人口和个人层面的死亡率数据，涉及除魁北克省外所有加拿大省份和地区的1,806,318名死者。研究发现住院死亡人数大幅且持续下降（从77.7%降至60.6%）。无论死者的年龄、性别、婚姻状况、是否出生在加拿大、城市和农村省份，以及除两种（罕见）死因外的所有死因，这种下降都是普遍存在的。这种转变是在没有旨在将死亡或临终护理从医院转移出去的政策或有目的的医疗保健规划的情况下发生的。在发达国家，最近死亡地点以及临终护理的地点和类型的变化模式似乎正在出现，这使得死亡地点趋势成为一个重要的研究课题。加拿大是一个重要的案例研究，用于突出死亡地点趋势的重要性，并揭示重要的潜在因果关系以及对临终政策和实践的影响。
