title: Place of Death: Trends Over the Course of a Decade: A Population-Based Study of Death Certificates From the Years 2001 and 2011.
abstract: BACKGROUND
  In Germany, data on place of death is recorded from death certificates, but not further analyzed. Consequently, hardly any information is available at the population level regarding the distribution of place of death (e.g. home, hospital, palliative care unit, nursing home, hospice).
  
  
  METHODS
  We carried out a descriptive statistical analysis of the registered places of death in evaluated death certificates from selected areas of Westphalia-Lippe for the years 2001 and 2011. Factors affecting the place of death were determined with binary multivariate regression.
  
  
  RESULTS
  We analyzed 24 009 death certificates (11 585 for 2001 and 12 424 for 2011). The distribution of places of death for the overall population was as follows (2001 vs. 2011): at home, 27.5% vs. 23.0% (p<0.001); in the hospital, 57.6% vs. 51.2% (p<0.001); on a palliative care unit, 0.0% vs. 1.0%, in a care or nursing home, 12.2% vs. 19.0% (p<0.001); in a hospice, 2.0% vs. 4.6% (p<0.001); elsewhere, 0.6% vs. 0.6% (p = 0.985); not indicated, 0.1% vs. 0.6% (p<0.001). Independent factors affecting the place of death were age, sex, place of residence, and the presence of cancer or of dementia.
  
  
  CONCLUSIONS
  Most people in Germany die in institutions; the most common place of death is still the hospital, where more than half of all deaths take place. Only one death in four occurs at home. There is a marked secular trend away from dying at home or in the hospital, in favor of dying in a care or nursing home; death in palliative care units and hospices is also becoming more common.
authors.affiliation: Department of Palliative Medicine, Munich University Hospital, Palliativnetz Bochum e. V., Bochum, Department of Anaesthesiology and Intensive Care Medicine, St. Josef Hospital, Katholisches Klinikum Bochum, University Hospital, Ruhr-University of Bochum.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Dasch
authors.forename: Klaus
authors.initials: K
authors.lastname: Blum
authors.forename: Philipp
authors.initials: P
authors.lastname: Gude
authors.forename: Claudia
authors.initials: C
authors.lastname: Bausewein
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003644:Death Certificates; D003704:Dementia / Q000401:mortality; D005260:Female; D005858:Germany / Q000453:epidemiology; D006738:Hospices / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D009369:Neoplasms / Q000401:mortality*; D009735:Nursing Homes / Q000706:statistics & numerical data*; D017678:Sex Distribution