2003 to 2017 saw increase in deaths at home, hospice facility
From 2003 to 2017, there was a decrease in deaths occurring in hospitals and nursing facilities and an increase in deaths at home and at hospice facilities, according to a research letter published in the Dec. 12 issue of the New England Journal of Medicine.
Sarah H. Cross, M.P.H., from the Duke University Sanford School of Public Policy in Durham, N.C., and Haider J. Warraich, M.D., from Veterans Affairs Boston Healthcare System, analyzed data for nearly 35.2 million natural deaths in the United States from 2003 through 2017.
The researchers found that from 2003 to 2017, there was a decrease in the number of deaths occurring in hospitals, from 39.7 to 29.8 percent, and at nursing facilities, from 23.6 to 20.8 percent. The number of deaths at home increased from 23.8 to 30.7 percent, and the number at hospice facilities increased from 0.2 to 8.3 percent. The odds of death at home were lower for younger patients, female patients, and racial and ethnic minorities. The greatest odds of death at home and at a hospice facility were seen for patients with cancer; they also had the lowest odds of death at a nursing facility relative to any other condition. Patients with dementia and respiratory disease had the greatest odds of death at a nursing facility and hospital, respectively.
"These findings should lead to prioritizing improvements in access to high-quality home care for older Americans with serious illnesses," the authors write.
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