title: Places of death from cancer in a rural location.
abstract: BACKGROUND
  Most people would like to die at home, however, this wish still cannot be realized to any satisfactory extent. Provision of qualified palliative care can increase the death rate at home. Distribution of places of death of cancer patients in rural locations and possible factors influencing this distribution are still unknown.
  
  
  METHODS
  We retrospectively evaluated the data relating to death certificates of cancer patients issued between 1997 and 2003 by the administrative district Sächsische Schweiz'.
  
  
  RESULTS
  In small-town and rural locations, the places of death from cancer were equally distributed among hospital and home. Patients living in a rural location and diagnosed as having breast cancer were more likely to die at home. Since 2001, the number of breast cancer patients dying at home has been increasing.
  
  
  CONCLUSIONS
  Rural locations provide favorable conditions for home deaths. High therapy costs and transfer of expensive therapies away from hospitals into the outpatient therapy sector appear to have an effect on the place where patients are finally cared for and where they eventually die. This circumstance meets the wishes of most patients and leads to a relevant cost saving for the healthcare system. An effective and rigorous health and economic policy is necessary in order to realize an extensive home care for terminally ill patients.
authors.affiliation: Practice and Day Clinic for Internal Medicine and Oncology, Neustadt/Sachsen, Germany. mail@drpapke.de
authors.forename: Jens
authors.initials: J
authors.lastname: Papke
authors.forename: Rainer
authors.initials: R
authors.lastname: Koch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000191:economics / Q000401:mortality / Q000523:psychology; D002755:Choice Behavior; D017046:Cost Savings; D003644:Death Certificates; D005260:Female; D005858:Germany; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000401:mortality* / Q000523:psychology; D010166:Palliative Care / Q000191:economics / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000191:economics / Q000706:statistics & numerical data*