Marcucci Fernando Cesar Iwamoto, Cabrera Marcos Aparecido Sarria
Departamento de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, PR, Brasil,
Cien Saude Colet. 2015 Mar;20(3):833-40. doi: 10.1590/1413-81232015203.04302014.
An aging population and epidemiological transition involves prolonged terminal illnesses and an increased demand for end-stage support in health services, mainly in hospitals. Changes in health care and government health policies may influence the death locations, making it possible to remain at home or in an institution. The scope of this article is to analyze death locations in the city of Londrina, State of Paraná, from 1996 to 2010, and to verify the influence of population and health policy changes on these statistics. An analysis was conducted into death locations in Londrina in Mortality Information System (SIM) considering the main causes and locations of death. There was an increase of 28% in deaths among the population in general, though 48% for the population over 60 years of age. There was an increase of deaths in hospitals, which were responsible for 70% of the occurrences, though death frequencies in others locations did not increase, and deaths in the home remained at about 18%. The locations of death did not change during this period, even with health policies that broadened care in other locations, such as the patient´s home. The predominance of hospital deaths was similar to other Brazilian cities, albeit higher than in other countries.
人口老龄化和流行病学转变涉及到晚期疾病的延长以及对卫生服务，主要是医院终末期支持需求的增加。医疗保健和政府卫生政策的变化可能会影响死亡地点，使得在家中或机构中离世成为可能。本文的范围是分析1996年至2010年巴拉那州隆德里纳市的死亡地点，并验证人口和卫生政策变化对这些统计数据的影响。利用死亡率信息系统（SIM）对隆德里纳市的死亡地点进行了分析，考虑了主要死因和死亡地点。总体人口死亡率上升了28%，而60岁以上人口死亡率上升了48%。医院死亡人数有所增加，占死亡总数的70%，而其他地点的死亡频率并未增加，在家中死亡的比例仍约为18%。尽管有卫生政策扩大了在其他地点（如患者家中）的护理，但在此期间死亡地点并未改变。医院死亡的主导地位与巴西其他城市相似，尽管高于其他国家。
