Cai Jiaoli, Zhao Hongzhong, Coyte Peter C
School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, Hubei, China.
Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada.
Int J Environ Res Public Health. 2017 Oct 11;14(10):1210. doi: 10.3390/ijerph14101210.
China is facing a dramatic aging of its population. Little is known about the factors that influence the place of death and the trends in the place of death for elderly people in China. The purposes of this study were: (1) to examine the impact of the socioeconomic status (SES) on place of death for elderly Chinese residents; and (2) to assess temporal trends in the place of death over the last 15 years. Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998-2012). Place-of-death as an outcome was dichotomized into either death at home or death outside the home. Logistic regression analyses were used to examine the impact of SES on place of death. The results showed that, of the 23,098 deaths during the study period, 87.78% occurred at home. The overall trend in home death has increased since 2005. SES was shown to be an important factor affecting place of death. The elderly with higher SES were more likely to die where health resources were concentrated, i.e., in a hospital or other type of institution. Our finding suggests that the trend towards a greater emphasis on death at home may call for the development of more supportive home care programs in China. Our finding also suggests that the socioeconomic differences in the place of death may be related to the availability of or access to health care services.
中国正面临着人口的急剧老龄化。对于影响中国老年人死亡地点的因素以及死亡地点的趋势，人们知之甚少。本研究的目的是：（1）考察社会经济地位（SES）对中国老年居民死亡地点的影响；（2）评估过去15年中死亡地点的时间趋势。数据来源于中国健康与养老追踪调查（CLHLS）（1998 - 2012年）。将死亡地点这一结果分为在家死亡或在家外死亡两类。采用逻辑回归分析来考察SES对死亡地点的影响。结果显示，在研究期间的23,098例死亡中，87.78%发生在家中。自2005年以来，在家死亡的总体趋势有所上升。SES被证明是影响死亡地点的一个重要因素。SES较高的老年人更有可能在医疗资源集中的地方死亡，即医院或其他类型的机构。我们的研究结果表明，更加注重在家死亡的趋势可能需要中国发展更多支持性的居家护理项目。我们的研究结果还表明，死亡地点的社会经济差异可能与医疗服务的可获得性或可及性有关。
