title: General practitioner awareness of preferred place of death and correlates of dying in a preferred place: a nationwide mortality follow-back study in the Netherlands.
abstract: To improve the quality of end-of-life care, general practitioner (GP) awareness of where their patients prefer to die is important. To examine GP awareness of patients' preferred place of death (POD), associated patient- and care-related characteristics, and the congruence between preferred and actual POD in The Netherlands, a mortality follow-back study was conducted between January 2005 and December 2006. Standardized registration forms were used to collect data on all nonsudden deaths (n=637) by means of the Dutch Sentinel Network, a nationally representative network of general practices. Forty-six percent of patients had GPs who were not aware of their preferred POD. Of those whose GPs were aware, 88% had preferred to die in a private or care home, 10% in a hospice or palliative care unit, and 2% in a hospital. GPs were informed by the patients themselves in 84% of cases. Having financial status "above average," a life-prolongation or palliative care goal, and using specialist palliative care services were associated with higher GP-awareness odds. Four-fifth of patients with known preferred POD died there. There is a potential for improving GP awareness of patients' preferred POD. Such awareness is enhanced when palliation is an active part of end-of-life care. The hospital is the POD least preferred by dying patients.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands. ebun.abarshi@vumc.nl
authors.forename: Ebun
authors.initials: E
authors.lastname: Abarshi
authors.forename: Bregje
authors.initials: B
authors.lastname: Onwuteaka-Philipsen
authors.forename: Gé
authors.initials: G
authors.lastname: Donker
authors.forename: Michael
authors.initials: M
authors.lastname: Echteld
authors.forename: Lieve
authors.initials: L
authors.lastname: Van den Block
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003625:Data Collection; D007722:Health Knowledge, Attitudes, Practice; D009426:Netherlands / Q000453:epidemiology; D010361:Patients / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000706:statistics & numerical data*