title: Characteristics influencing location of death for children with life-limiting illness.
abstract: OBJECTIVE
  To determine whether demographic and diagnostic characteristics were associated with location of death in a series of children with life-limiting illnesses.
  
  
  METHODS
  A population-level case series was carried out by reviewing mortality records. Sociodemographic characteristics, diagnosis and referral to paediatric palliative care (PPC) were analysed for association with location of death.
  
  
  METHODS
  New Zealand
  
  
  METHODS
  Children and young people aged 28 days-18 years who died from a life-limiting illness between 2006 and 2009 inclusive.
  
  
  METHODS
  Location of death-home, hospital, other.
  
  
  RESULTS
  Of 494 deaths, 53.6% (256/494) died in hospital and 41.9% (203/494) died at home. Asian (OR=2.66, 95% CI 1.17 to 6.04) and Pacific children (OR=2.22, 95% CI 1.15 to 4.29) had an increased risk of death in hospital compared with European children, while children with cancer (adjusted OR=0.48, 95% CI 0.3 to 0.75) and children referred to the PPC service (adjusted OR=0.60, 95% CI 0.38 to 0.96) had a decreased risk. Population-attributable risk for referral to the PPC service was 28.2% (95% CI 11.25 to 47.75).
  
  
  CONCLUSIONS
  Most children in New Zealand with a life-limiting illness die in hospital with a significant influence resulting from ethnic background, diagnosis and referral to the PPC service. These findings have implications for resourcing PPC services and end-of-life care.
authors.affiliation: Starship Palliative Care Service, Starship Children's Health, Auckland City Hospital, Private Bag, 92024, Auckland 1142, New Zealand. emschang@yahoo.co.nz
authors.forename: Emily
authors.initials: E
authors.lastname: Chang
authors.forename: Rod
authors.initials: R
authors.lastname: MacLeod
authors.forename: Ross
authors.initials: R
authors.lastname: Drake
mesh_terms: D000293:Adolescent; D044466:Asian People / Q000208:ethnology*; D002648:Child; D046688:Child Mortality / Q000208:ethnology*; D002675:Child, Preschool; D003643:Death; D017052:Hospital Mortality / Q000208:ethnology*; D006801:Humans; D007223:Infant; D009520:New Zealand; D012111:Residence Characteristics; D012189:Retrospective Studies; D013727:Terminal Care / Q000706:statistics & numerical data*; D044465:White People / Q000208:ethnology*
keywords: Paediatric Practice; Palliative Care