Mary Potter Hospice, Wellington, Aotearoa New Zealand.
Palliat Med. 2012 Jun;26(4):342-9. doi: 10.1177/0269216311412229. Epub 2011 Jun 22.
Because socioeconomic and cultural factors contribute to where one dies, it is important to document place of death determinants in diverse societies.
The purpose of this study was to describe where persons in an Aotearoa New Zealand hospice die, and to identify factors that are associated with place of death.
A retrospective chart review was conducted.
SETTING/PARTICIPANTS: Data were extracted from the charts of all patients receiving services from one hospice (i.e. secondary care) for whom death occurred during 2006-2008; 1268 cases for whom place of death was recorded comprise this sample.
For close to half (47%), death occurred in the hospice inpatient unit, whereas 29% died at home, 8% died in an acute hospital setting, and 17% died in an aged/residential care facility. Bivariate analyses showed that persons who die in an aged/residential care facility are more likely to be aged 65 or older, unmarried, have a non-cancer diagnosis, and are likely poorer. Asians, those aged less than 65, those with cancer, and those admitted initially to hospice for respite care tended to die in the hospice inpatient unit. Multinominal logistic regression indicated that dying at home was only predicted by being from a Pacific Island.
Age, economics, diagnosis, ethnicity, marital status, and whether one enters a hospice service for (at least in part) respite were all associated to a certain extent with where one dies. These findings contribute to the growing evidence linking various factors, especially ethnic groups, with place of death.
由于社会经济和文化因素会影响死亡地点,因此记录不同社会中死亡地点的决定因素非常重要。
本研究旨在描述新西兰奥塔哥地区临终关怀机构中患者的死亡地点,并确定与死亡地点相关的因素。
回顾性病历审查。
地点/参与者:从 2006 年至 2008 年期间在一家临终关怀机构(即二级保健)接受服务且死亡的所有患者的病历中提取数据;本样本包括记录了死亡地点的 1268 例患者。
将近一半(47%)的死亡发生在临终关怀住院病房,29%的死亡发生在患者家中,8%的死亡发生在急性医院,17%的死亡发生在老年/疗养护理机构。单变量分析显示,在老年/疗养护理机构死亡的患者更可能年龄在 65 岁或以上、未婚、患有非癌症诊断、且更贫困。亚洲人、年龄小于 65 岁的人、患有癌症的人以及最初因缓解治疗而入住临终关怀机构的人更倾向于在临终关怀住院病房死亡。多项逻辑回归表明,在家中死亡仅与来自太平洋岛屿有关。
年龄、经济状况、诊断、种族、婚姻状况以及是否因(至少部分)缓解而进入临终关怀机构在一定程度上都与死亡地点有关。这些发现有助于越来越多的证据将各种因素(尤其是族裔群体)与死亡地点联系起来。