title: Place of death and hospital care for children who died of cancer in England, 1999-2006.
abstract: OBJECTIVE
  To describe patterns of hospital care and to evaluate factors influencing place of death for children who died after a diagnosis of cancer in England during 1999-2006.
  
  
  METHODS
  Registrations of children on the National Registry of Childhood Tumours (NRCT) who were diagnosed with cancer and died during 1999-2006 in England were linked to the Hospital Episode Statistics (HES) and to death certificates. Multivariable logistic modelling was used to assess factors that influence dying at home or in hospital.
  
  
  RESULTS
  1864 (96%) of children with cancer registrations were linked to HES records. The validation of hospital as a place of death and ethnicity between data sources was good, although anomalies within HES data exist. Similar proportions of children are dying at home (45%) and in hospital (47%), and the percentage dying in a hospice or care home increased from 2% to 10%. Of the children who died in hospital, 74% were admitted as emergencies or as a transfer from another hospital. Greater proportions of children were diagnosed with a leukaemia or lymphoma, those dying within six months of diagnosis, Asian and Black children, those from a deprived background and those not treated in a CCLG centre died in a hospital.
  
  
  CONCLUSIONS
  Patterns of hospital care varied considerably by type of cancer, death within six months of diagnosis, ethnicity and deprivation. Further research is required to elucidate explanations for these patterns and to evaluate methods to increase the proportion of children dying at home who wish to do so.
authors.affiliation: Childhood Cancer Research Group, Richards Building, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LG, UK. anjali.shah@ccrg.ox.ac.uk
authors.forename: Anjali
authors.initials: A
authors.lastname: Shah
authors.forename: Nicole
authors.initials: N
authors.lastname: Diggens
authors.forename: Charles
authors.initials: C
authors.lastname: Stiller
authors.forename: Dermot
authors.initials: D
authors.lastname: Murphy
authors.forename: Jane
authors.initials: J
authors.lastname: Passmore
authors.forename: Michael F G
authors.initials: MF
authors.lastname: Murphy
mesh_terms: D000293:Adolescent; D001293:Attitude to Death; D002648:Child; D002675:Child, Preschool; D003643:Death; D004739:England / Q000453:epidemiology; D017051:Hospice Care / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000208:ethnology / Q000401:mortality*; D010166:Palliative Care / Q000706:statistics & numerical data*; D012042:Registries; D012111:Residence Characteristics; D012189:Retrospective Studies; D013727:Terminal Care / Q000706:statistics & numerical data*