title: Place of death of people living with Parkinson's disease: a population-level study in 11 countries.
abstract: BACKGROUND
  Most people prefer to receive end-of-life care in familiar surroundings rather than in hospital. This study examines variation in place of death for people dying from Parkinson's disease (PD) across 11 European and non-European countries.
  
  
  METHODS
  Using death certificate data of 2008 for Belgium, France, Italy, Hungary, Czech Republic, New Zealand, USA, Canada, Mexico, South Korea and Spain for all deaths with PD as an underlying cause (ICD-10 code: G20) cross-national differences in place of death were examined. Associations between place of death and patient socio-demographic and regional characteristics were evaluated using multivariable binary logistic regression analyses.
  
  
  RESULTS
  The proportion of deaths in hospital ranged from 17% in the USA to 75% in South Korea. Hospital was the most prevalent place of death in France (40%), Hungary (60%) and South Korea; nursing home in New Zealand (71%), Belgium (52%), USA (50%), Canada (48%) and Czech Republic (44%); home in Mexico (73%), Italy (51%) and Spain (46%). The chances of dying in hospital were consistently higher for men (Belgium, France, Italy, USA, Canada), those younger than 80 years (Belgium, France, Italy, USA, Mexico), and those living in areas with a higher provision of hospital beds (Italy, USA).
  
  
  CONCLUSIONS
  In several countries a substantial proportion of deaths from PD occurs in hospitals, although this may not be the most optimal place of terminal care and death. The wide variation between countries in the proportion of deaths from PD occurring in hospital indicates a potential for many countries to reduce these proportions.
authors.affiliation: Department of Palliative Care, King's College London, Cicely Saunders Institute, Policy & Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK. Katrien.Moens@kcl.ac.uk.
authors.forename: Katrien
authors.initials: K
authors.lastname: Moens
authors.affiliation: Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium. Dirk.Houttekier@vub.ac.be.
authors.forename: Dirk
authors.initials: D
authors.lastname: Houttekier
authors.affiliation: Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium. lvdblock@vub.ac.be.
authors.forename: Lieve
authors.initials: L
authors.lastname: Van den Block
authors.affiliation: Department of Palliative Care, King's College London, Cicely Saunders Institute, Policy & Rehabilitation, Bessemer Road, Denmark Hill, London, SE5 9PJ, UK. Richard.Harding@kcl.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
authors.affiliation: French National Observatory on End-of-Life Care, Paris, France. lucas.morin.observatoire@gmail.com.
authors.forename: Lucas
authors.initials: L
authors.lastname: Morin
authors.affiliation: Italian National Institute of Statistics, Rome, Italy. stmarche@istat.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Marchetti
authors.affiliation: University of Pécs Medical School, Pécs, Hungary. agnes.csikoska@gmail.com.
authors.forename: Agnes
authors.initials: A
authors.lastname: Csikos
authors.affiliation: Center for Palliative Care, Prague, Czech Republic. martin.loucka@gmail.com.
authors.forename: Martin
authors.initials: M
authors.lastname: Loucka
authors.affiliation: Hospice Waikato, Hamilton, New Zealand. wayne.naylor@hospicewaikato.org.nz.
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Naylor
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada. donna.wilson@ualberta.ca.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Wilson
authors.affiliation: Brown University, Department of Community Health, Rhode Island, USA. joan_teno@brown.edu.
authors.forename: Joan
authors.initials: J
authors.lastname: Teno
authors.affiliation: The University of Texas, MD Anderson Cancer Center, Houston, TX, USA. mcardena@mdanderson.org.
authors.forename: Marylou
authors.initials: M
authors.lastname: Cardenas-Turanzas
authors.affiliation: Dongduk Women's University, Seoul, Korea. yrh759@dongduk.ac.kr.
authors.forename: YongJoo
authors.initials: Y
authors.lastname: Rhee
authors.affiliation: Consejería de Igualdad, Salud y Bienestar Social. Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA), Sevilla, Spain. fjavier.garcia.leon@juntadeandalucia.es.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Garcia-Leon
authors.affiliation: Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium. Luc.Deliens@vub.ac.be.
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.affiliation: Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium. Joachim.Cohen@vub.ac.be.
authors.forename: Joachim
authors.initials: J
authors.lastname: Cohen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003431:Cross-Cultural Comparison; D003643:Death; D003644:Death Certificates; D005260:Female; D006742:Hospital Bed Capacity; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D010300:Parkinson Disease / Q000401:mortality*; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D013727:Terminal Care / Q000706:statistics & numerical data*