Increased rate of home-death among patients in a Danish general practice.

INTRODUCTION

Most terminally ill patients wish to die at home. The aim of this study was to investigate whether the home-death rate was higher than the Danish average in a general practice with a systematic approach to palliative care and to examine if the number of clinical contacts between the practice and its patients was associated with place of death.

METHODS

In a large (6,500 patients) four-doctor general practice outside of Copenhagen, adult patients who died between 2015 and 2018 were identified. Accidental or suicidal deaths were excluded. Data on age, gender, diagnosis, place of death, the primarily responsible physician and the number of clinical contacts during the last four months of life were retrieved from the patients' medical files.

RESULTS

A total of 201 patients were included (mean age at time of death = 82.4 years) of whom 99 patients (49%) died at home/in a nursing home and 93 patients (46%) died in hospital/hospice. Compared with regional data, the proportion of home-death was higher in the study population (national (43%, p = 0.09), regional (39%, p = 0.01), municipal (44%, p = 0.18)). The odds of death in hospital were nine times higher if no GP was directly involved in the palliative phase (p = 0.001). However, no significant difference in the number of contacts with the GP between patients who died at home or in hospital/hospice was observed.

CONCLUSIONS

The proportion of home-death in the studied general practice was higher than home-death recorded in regional data. Having a GP involved in the palliative phase was associated with home-death independently of the number of GP contacts in the trajectory.

FUNDING

The study received funding from the PLU-Fund (Praktiserende Lægers Uddannelsesfond).

TRIAL REGISTRATION

not relevant.