title: Place of death in the population dying from diseases indicative of palliative care need: a cross-national population-level study in 14 countries.
abstract: BACKGROUND
  Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differences in the place of death.
  
  
  METHODS
  Death certificate data for all deaths in 2008 (age ≥1 year) in Belgium, Canada, the Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (Andalusia), the USA and Wales caused by cancer, heart/renal/liver failure, chronic obstructive pulmonary disease, diseases of the nervous system or HIV/AIDS were linked with national or regional healthcare statistics (N=2,220,997).
  
  
  RESULTS
  13% (Canada) to 53% (Mexico) of people died at home and 25% (the Netherlands) to 85% (South Korea) died in hospital. The strength and direction of associations between home death and cause of death, sociodemographic and healthcare availability factors differed between countries. Differences between countries in home versus hospital death were only partly explained by differences in these factors.
  
  
  CONCLUSIONS
  The large differences between countries in and beyond Europe in the place of death of people in potential need of palliative care are not entirely attributable to sociodemographic characteristics, cause of death or availability of healthcare resources, which suggests that countries' palliative and end-of-life care policies may influence where people die.
authors.affiliation: Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.
authors.forename: Lara
authors.initials: L
authors.lastname: Pivodic
authors.affiliation: Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Pardon
authors.affiliation: French National Observatory on End-of-Life Care, Paris, France Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Lucas
authors.initials: L
authors.lastname: Morin
authors.affiliation: Faculty of Health Sciences, University of Southampton, Hampshire, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Addington-Hall
authors.affiliation: ISPO, Cancer Prevention and Research Institute, Florence, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Miccinesi
authors.affiliation: The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Marylou
authors.initials: M
authors.lastname: Cardenas-Turanzas
authors.affiliation: EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Bregje
authors.initials: B
authors.lastname: Onwuteaka-Philipsen
authors.affiliation: Hospice Waikato, Hamilton, New Zealand.
authors.forename: Wayne
authors.initials: W
authors.lastname: Naylor
authors.affiliation: Regional Ministry of Equality, Health and Social Policies in Andalusia, Seville, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Ruiz Ramos
authors.affiliation: Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.
authors.forename: Lieve
authors.initials: L
authors.lastname: Van den Block
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Wilson
authors.affiliation: Center for Palliative Care, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Loucka
authors.affiliation: University of Pécs Medical School, Pécs, Hungary.
authors.forename: Agnes
authors.initials: A
authors.lastname: Csikos
authors.affiliation: Dongduk Women's University, Seoul, South Korea.
authors.forename: Yong Joo
authors.initials: YJ
authors.lastname: Rhee
authors.affiliation: Brown University, School of Public Health, Providence, Rhode Island, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Teno
authors.affiliation: Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.affiliation: Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.
authors.forename: Dirk
authors.identifier: http://orcid.org/0000-0003-0837-9898
authors.initials: D
authors.lastname: Houttekier
authors.affiliation: Department of Family Medicine & Chronic Care, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.
authors.forename: Joachim
authors.initials: J
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D002648:Child; D002675:Child, Preschool; D003643:Death; D003644:Death Certificates; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D038622:Internationality; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012111:Residence Characteristics; D019452:Terminally Ill; D055815:Young Adult
keywords: CHRONIC DI; DEATH CERTIFICATION; PALLIATIVE CARE; PUBLIC HEALTH