Factors associated with lower rates of in-hospital death.
OBJECTIVE
Examine individual and statewide factors associated with hospital as location of death.


METHODS
An observational study using large national databases.


METHODS
All 1997 U.S. decedents (all ages, all causes.)


RESULTS
The West has the lowest percentage of deaths occurring in an acute care hospital, and the highest percentage of deaths at home. Increased hospital bed availability is significantly associated with greater chance of dying in an acute care hospital. Hispanic, nonwhite, and less educated decedents are more likely to die in a hospital (as opposed to home or nursing home).


CONCLUSIONS
Hospital bed availability profoundly influences the likelihood of dying in a hospital. Individual characteristics such as race and education affect location of death as well. These three factors account for approximately 75% of the trend in the West to a lower in-hospital death rate and more deaths at home. Additional factors may include formal out of hospital orders to limit transfer.
Hansen
Susan M
SM
Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, Oregon 97201-3098, USA. hansens@ohsu.edu
Tolle
Susan W
SW
Martin
Diane P
DP
D000368:Aged; D002423:Cause of Death; D016208:Databases, Factual; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012923:Social Class; D014481:United States