Place of death in metropolitan regions: metropolitan versus non-metropolitan variation in place of death in Belgium, The Netherlands and England.
Place of death is an important societal indicator of end-of-life quality for the terminally ill. Using death certificate data, we examined metropolitan/non-metropolitan variation in place of death of patients with life-limiting conditions in Belgium, The Netherlands and England. Metropolitan patients were less likely to die at home and, in England, less likely to die in care homes, than non-metropolitan terminally ill. We found a lesser degree of social support and lower availability of care home beds as partial explanations of the metropolitan/non-metropolitan discrepancy. These findings warrant specific approaches to end-of-life care in metropolitan areas.
End-of-Life Care Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium. dirk.houttekier@vub.ac.be
Dirk
D
Houttekier
Joachim
J
Cohen
Johan
J
Bilsen
Julia
J
Addington-Hall
Bregje
B
Onwuteaka-Philipsen
Luc
L
Deliens
D001530:Belgium / Q000453:epidemiology; D003643:Death; D003644:Death Certificates; D004739:England / Q000453:epidemiology; D006699:Home Care Services; D006801:Humans; D007326:Institutionalization; D009426:Netherlands / Q000453:epidemiology; D010166:Palliative Care; D012424:Rural Population; D019452:Terminally Ill; D014505:Urban Population