title: Preference for place of death in Germany.
abstract: BACKGROUND
  Dying in the preferred place is considered a key requirement for a "good death." The aims of our study were to explore preferred places of death of deceased people and their bereaved relatives in Rhineland-Palatinate (Germany). We further wanted to assess the congruence between preferred and actual place of death.
  
  
  METHODS
  The cross-sectional study was based on a random sample of 5000 inhabitants of Rhineland-Palatinate (Germany) who died between May 25 and August 24, 2008. Relatives of these deceased persons were interviewed by a written survey.
  
  
  RESULTS
  After removing duplicates, 4967 questionnaires were sent out, 3832 delivered, and 1378 completed, yielding a response rate of 36.0%. Regarding the deceased, 93.8% wanted to die at home, 0.7% in a hospital, 2.8% in palliative care, 2.4% in a nursing home, and 0.3% elsewhere. The figures for the relatives were 80.7%, 4.3%, 7.5%, 7.1%, and 0.5%, respectively. Of the deceased 58.9% and of the relatives 59.1% had their wish fulfilled. Logistic regression analysis revealed that living in a rural municipality (adjusted odds ratio [aOR]: 1.88; 95% confidence interval [CI]: 1.02-3.43), rural town (aOR: 2.30; 95% CI: 1.17-4.49) or small town (aOR: 1.95; 95% CI: 1.04-3.68), having a nonworking relative (aOR: 1.79; 95% CI: 1.16-2.76), and living together with a relative (aOR: 2.28; 95% CI:1.57-3.32) increases the probability to die in the preferred place.
  
  
  CONCLUSIONS
  Because the availability of a relative was the most important factor to die in the preferred place, relatives of dying people should be supported in providing informal care. The introduction of palliative home care teams should allow more people to die in their preferred place by easing the burden of informal carers.
authors: Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Germany. escobar@uni-mainz.de
authors: Luis Carlos
authors: LC
authors: Escobar Pinzon
authors: Matthias
authors: M
authors: Claus
authors: Kirsten Isabel
authors: KI
authors: Zepf
authors: Stephan
authors: S
authors: Letzel
authors: Sabine
authors: S
authors: Fischbeck
authors: Martin
authors: M
authors: Weber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D002648:Child; D002675:Child, Preschool; D003142:Communication; D016001:Confidence Intervals; D003625:Data Collection; D003657:Decision Making; D005260:Female; D005843:Geography; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D057240:Patient Preference / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult