title: [Dying in Rhineland-Palatinate (Germany): preferred and actual place of death].
abstract: BACKGROUND
  Until now, no official statistics about the place of death in Germany exist.
  
  
  OBJECTIVE
  The aim of our study was to determine where people died in Rhineland-Palatinate (Germany) in 2008, and which place of death was preferred. We further aimed to identify influencing factors on dying at home vs. dying in an -institution.
  
  
  METHODS
  Our cross-sectional survey was based on a random sample of 5000 inhabitants of Rhineland-Palatinate (Germany) that had died between May and August 2008. Relatives of these deceased persons received a questionnaire containing socio-demographic and health-specific questions.
  
  
  RESULTS
  After removing duplicates, 4967 questionnaires were sent out. 3832 questionnaires were delivered and 1378 completed, leading to a response rate of 36.0%. 38.2% of the deceased died at home, 39.3% in a hospital, 13.4% in a nursing home, 7.5% in a palliative care facility and 1.6% elsewhere. 93.8% of the deceased who expressed a preference wanted to die at home. Altogether, 58.3% had their wish fulfilled. Suffering from cancer (aOR:1.30; 95% CI:1.01-1.68), social support (aOR being married:1.33; 95% CI:1.04-1.70; aOR having a non-/part-time working relative:1.71; 95% CI: 1.28-2.29), a high care level (aOR care level II:2.79; 95% CI: 2.06-3.79; aOR care level III: 4.96; 95% CI:3.40-7.24), and living in a rural municipality (aOR: 1.36; 95% CI:1.01-1.84) were factors favouring=BE; AE=favoring home death compared with institutional death.
  
  
  CONCLUSIONS
  Altogether, 4 of 10 patients who wanted to die at home could not die in their preferred place. Future studies should focus on the question as to what extent the strengthening of outpatient care structures, e. g., by introducing specialised=BE spezialized=AE outpatient palliative care, can allow more people to die at home.
authors.affiliation: Institut für Arbeits-, Sozial- und Umweltmedizin, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.
authors.forename: L C
authors.initials: LC
authors.lastname: Escobar Pinzon
authors.affiliation: Institut für Arbeits-, Sozial- und Umweltmedizin, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.
authors.forename: M
authors.initials: M
authors.lastname: Claus
authors.affiliation: Institut für Arbeits-, Sozial- und Umweltmedizin, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.
authors.forename: K I
authors.initials: KI
authors.lastname: Zepf
authors.affiliation: Institut für Arbeits-, Sozial- und Umweltmedizin, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.
authors.forename: S
authors.initials: S
authors.lastname: Letzel
authors.affiliation: Interdisziplinäre Einrichtung für Palliativmedizin, III. Medizinische Klinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.
authors.forename: M
authors.initials: M
authors.lastname: Weber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000706:statistics & numerical data*; D011159:Population Surveillance; D062211:Spatio-Temporal Analysis; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013727:Terminal Care / Q000706:statistics & numerical data*