title: Place of death and its determinants for patients with cancer in Singapore: an analysis of data from the Singapore Cancer Registry, 2000-2009.
abstract: OBJECTIVE
  To describe the place of death for patients with cancer in Singapore from 2000 to 2009, and determinants of death at home and in in-patient hospice compared to death in hospital.
  
  
  METHODS
  Cross-sectional analysis of all patients registered with the Singapore Cancer Registry who had died in the study period (N=52120). Places of death were grouped as homes, in-patient hospices, hospitals and others. For determinants of death at home and in in-patient hospice, covariates adjusted for in logistic regression analyses were age group, gender, ethnic group, primary tumour site, stage at diagnosis, duration and cause of death.
  
  
  RESULTS
  In the 10-year period, 52.9% of patients with cancer had died in the hospital, 30.3% died at home and 10.7% in in-patient hospice. Determinants of death at home were older age, female (odds ratio OR 1.23, 95% confidence interval, CI 1.17-1.29), Malay (OR 2.28, 95% CI 2.13-2.44), cancers of the colo-rectum, liver, stomach, pancreas and nasopharynx (compared to lung cancer), duration of illness of 1-5 years (OR 1.40, 95% CI 1.34-1.48), primary cause of death being 'neoplasms' (OR 2.97, 95% CI 2.79-3.17). Determinants of death in in-patient hospice were older age, distant metastasis (OR 1.35, 95% CI 1.21-1.50) and primary cause of death being 'neoplasms' (OR 20.07, 95% CI 16.05-25.09).
  
  
  CONCLUSIONS
  Knowledge about place of death and its determinants will facilitate the planning of healthcare services to enable patients with terminal cancer to die at home and in in-patient hospices, thereby avoiding inappropriate hospitalization at the end of life.
authors.affiliation: Lien Centre for Palliative Care, Duke-NUS Graduate Medical School, National University of Singapore, Singapore. chingye.hong@gmail.com
authors.forename: Ching Ye
authors.initials: CY
authors.lastname: Hong
authors.forename: Khuan Yew
authors.initials: KY
authors.lastname: Chow
authors.forename: Jissy
authors.initials: J
authors.lastname: Poulose
authors.forename: Ai Zhen
authors.initials: AZ
authors.lastname: Jin
authors.forename: Anju
authors.initials: A
authors.lastname: Devi
authors.forename: Eddie Meng Fai
authors.initials: EM
authors.lastname: Chee
authors.forename: Cynthia
authors.initials: C
authors.lastname: Goh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005843:Geography; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data; D017051:Hospice Care / Q000379:methods / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D016017:Odds Ratio; D017060:Patient Satisfaction; D012042:Registries; D012737:Sex Factors; D012846:Singapore