Hospital remains most common place of death for cancer patients in England

In England, hospital is still the most common place for patients with cancer to die but an increase in home and hospice deaths since 2005 suggests that the National End of Life Care Programme (a Programme to promote the rollout of national end-of-life care initiatives) has helped more people to die at their preferred place of death, according to a UK study funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme, published in this week's PLOS Medicine.

In a large analysis led by Dr Wei Gao and Professor Irene Higginson from King's College London, the authors used registration data collected by the Office of National Statistics to identify all 2.28 million adult cancer deaths in England between 1993 and 2010.

Throughout the study period, the authors found that hospital was the commonest place of death—48% of cancer deaths—whereas 24.5% deaths of cancer occurred at home and 16.4% occurred in hospices.

However, the authors found that the proportion of home deaths increased after 2005 whereas the proportion of hospital deaths declined. The proportion of deaths in hospices also increased over the study period. The National End of Life Care Programme in England was launched in November 2004.

Importantly, the authors also found that being single, widowed or divorced was linked with a higher chance of dying in hospital than being married. Being aged over 75 years was also linked to a higher chance of dying in hospital than in younger age groups although older people were more likely to die at home or in a hospice after 2006 than in earlier periods. Cancer type also played an important role in place of death: for example, patients who died from blood or lung cancer were more likely to die in hospital than patients with colorectal cancer throughout the study period.

The authors say: "This large-scale, population-based study found that hospitals remain the most common place of death for patients with cancer. Following a prolonged period of plateau, there was a steady downward trend in hospital deaths (about 50%) from 2005 onwards. The pattern was mirrored by increasing home deaths."

They continue: "This trend coincides with the launch of a National End of Life Care Programme in November 2004 in England, which was based on research evidence about patient preferences and possible solutions.

The authors conclude: "More efforts are needed to reduce hospital deaths. Healthcare facilities should be improved and enhanced to support the increased home and deaths. "

They add: "People who are single, widowed or divorced should be a focus for end-of-life care improvement, along with known at risk groups such as haematological cancer, lung , older age and deprivation."

More information: Gao W, Ho YK, Verne J, Glickman M, Higginson IJ, et al. (2013) Changing Patterns in Place of Cancer Death in England: A Population-Based Study. PLOS Med 10(3): e1001410. doi:10.1371/journal.pmed.1001410

add to favorites email to friend print save as pdf

Related Stories

UK death in a home setting on the rise

Jan 19, 2012

Although around two thirds of us would prefer to die at home, in the developed world the trend in recent years has been for the majority to spend their final days in an institutional setting. But according to new research ...

Palliative care experts call for better home care

Sep 25, 2012

Improved home care resources for people with conditions such as dementia, who would prefer to die at home, are key to providing better end of life care and reducing the strain of the UK's ageing population on the NHS, according ...

Hospice visit number affects ability to die at home

Jun 27, 2012

(HealthDay) -- Hospice patients with cancer are more likely to be able to die in the setting of their choice if they receive at least one hospice visit per day during the first four days of hospice care, according ...

Recommended for you

Genetics of cancer: Non-coding DNA can finally be decoded

3 hours ago

Cancer is a disease of the genome resulting from a combination of genetic modifications (or mutations). We inherit from our parents strong or weak predispositions to developing certain kinds of cancer; in addition, we also ...

Statin use decreases the risk of Barrett's esophagus

5 hours ago

Statins, a class of drugs commonly used to lower cholesterol levels, significantly reduce a patient's risk of developing Barrett's esophagus, according to a new study in Gastroenterology, the official journal of the Americ ...

User comments