Departamento de Enfermería, Universidad de Alicante, Alicante, España.
Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-Fundación FISABIO), Alicante, España.
Eur J Public Health. 2019 Aug 1;29(4):608-615. doi: 10.1093/eurpub/cky267.
Although studies suggest that most people prefer to die at home, not enough is known about place of death patterns by cause of death considering sociodemographic factors. The objective of this study was to determine the place of death in the population and to analyze the sociodemographic variables and causes of death associated with home as the place of death.
Cross-sectional population-based study. All death certificate data on the residents in Spain aged 15 or over who died in Spain between 2012 and 2015 were included. We employed multinomial logistic regression to explore the relation between place of death, sociodemographic variables and cause of death classified according to the International Classification of Diseases, 10th revision, and to conditions needing palliative care.
Over half of all deaths occurred in hospital (57.4%), representing double the frequency of deaths that occurred at home. All the sociodemographic variables (sex, educational level, urbanization level, marital status, age and country of birth) were associated with place of death, although age presented the strongest association. Cause of death was the main predictor with heart disease, neurodegenerative disease, Alzheimer's disease, dementia and senility accounting for the highest percentages of home deaths.
Most people die in hospital. Cause of death presented a stronger association with place of death than sociodemographic variables; of these latter, age, urbanization level and marital status were the main predictors. These results will prove useful in planning end-of-life care that is more closely tailored to people's circumstances and needs.
尽管研究表明大多数人更愿意在家中离世，但对于与社会人口因素相关的死因死亡地点模式，人们知之甚少。本研究的目的是确定人群的死亡地点，并分析与作为死亡地点的家庭相关的社会人口学变量和死因。
这是一项基于人群的横断面研究。纳入了 2012 年至 2015 年期间在西班牙死亡的年龄在 15 岁及以上的西班牙居民的所有死亡证明数据。我们采用多项逻辑回归分析来探讨死亡地点、社会人口学变量与死因之间的关系，死因根据国际疾病分类，第 10 次修订版进行分类，并根据需要姑息治疗的条件进行分类。
超过一半的死亡发生在医院（57.4%），是家中死亡的两倍。所有社会人口学变量（性别、教育水平、城市化水平、婚姻状况、年龄和出生国）都与死亡地点有关，尽管年龄的关联最强。死因是死亡地点的主要预测因素，心脏病、神经退行性疾病、阿尔茨海默病、痴呆和衰老导致了在家中死亡的比例最高。
大多数人在医院去世。死因与死亡地点的关联强于社会人口学变量；在这些变量中，年龄、城市化水平和婚姻状况是主要的预测因素。这些结果将有助于规划更符合人们的情况和需求的临终关怀。
