title: Death in hospital and at home: population and health policy influences in Londrina, State of Paraná, Brazil (1996-2010).
abstract: An aging population and epidemiological transition involves prolonged terminal illnesses and an increased demand for end-stage support in health services, mainly in hospitals. Changes in health care and government health policies may influence the death locations, making it possible to remain at home or in an institution. The scope of this article is to analyze death locations in the city of Londrina, State of Paraná, from 1996 to 2010, and to verify the influence of population and health policy changes on these statistics. An analysis was conducted into death locations in Londrina in Mortality Information System (SIM) considering the main causes and locations of death. There was an increase of 28% in deaths among the population in general, though 48% for the population over 60 years of age. There was an increase of deaths in hospitals, which were responsible for 70% of the occurrences, though death frequencies in others locations did not increase, and deaths in the home remained at about 18%. The locations of death did not change during this period, even with health policies that broadened care in other locations, such as the patient´s home. The predominance of hospital deaths was similar to other Brazilian cities, albeit higher than in other countries.
authors.affiliation: Departamento de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, PR, Brasil, fcim@msn.com.
authors.forename: Fernando Cesar Iwamoto
authors.initials: FC
authors.lastname: Marcucci
authors.affiliation: Departamento de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, PR, Brasil, fcim@msn.com.
authors.forename: Marcos Aparecido Sarria
authors.initials: MA
authors.lastname: Cabrera
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003643:Death; D016021:Epidemiologic Studies; D006291:Health Policy; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008875:Middle Aged; D013727:Terminal Care; D055815:Young Adult