TY - JOUR
T1 - Hospital versus home death
T2 - Results from the Mexican health and aging study
AU - Cárdenas-Turanzas, Marylou
AU - Torres-Vigil, Isabel
AU - Tovalín-Ahumada, Horacio
AU - Nates, Joseph L.
N1 - Funding Information:
Dr. Isabel Torres-Vigil was supported in part by the National Cancer Institute ( 3R01CA122292-03S1 ). The authors declare no conflicts of interest. The authors wish to thank John Le Bas and Allison De la Rosa for their editorial assistance in completing this article.
PY - 2011/5
Y1 - 2011/5
N2 - Context: Characterizing where people die is needed to inform palliative care programs in Mexico. Objectives: To determine whether access to health care influences the place of death of older Mexicans and examine the modifying effects of demographic and clinical characteristics. Methods: We analyzed 2001 baseline and 2003 follow-up data from the Mexican Health and Aging Study. Cases included adults who completed the baseline interview and died before the follow-up interview and for whom a proxy interview was obtained in 2003. The main outcome variable was the place of death (hospital vs. home). The predictors of the place of death were identified using logistic regression analysis. Results: The study group included 473 deceased patients; 52.9% died at home. Factors associated with hospital death were having spent at least one night in a hospital during the last year of life (odds ratio [OR]: 6.73; 95% confidence interval [CI]: 3.29, 13.78) and dying in a city other than the city of usual residence (OR: 4.68, 95% CI: 2.56, 8.57). Factors associated with home death were not having health care coverage (OR: 2.78, 95% CI: 1.34, 5.88), living in a city of less than 100,000 residents (OR: 2.44, 95% CI: 1.43, 4.17), and older age (OR: 1.03, 95% CI: 1.01, 1.05). Conclusion: Older Mexicans with access to health care services were more likely to die in the hospital even after controlling for important clinical and demographic characteristics. Findings from the study may be used to plan the provision of accessible end-of-life hospital and home-based services.
AB - Context: Characterizing where people die is needed to inform palliative care programs in Mexico. Objectives: To determine whether access to health care influences the place of death of older Mexicans and examine the modifying effects of demographic and clinical characteristics. Methods: We analyzed 2001 baseline and 2003 follow-up data from the Mexican Health and Aging Study. Cases included adults who completed the baseline interview and died before the follow-up interview and for whom a proxy interview was obtained in 2003. The main outcome variable was the place of death (hospital vs. home). The predictors of the place of death were identified using logistic regression analysis. Results: The study group included 473 deceased patients; 52.9% died at home. Factors associated with hospital death were having spent at least one night in a hospital during the last year of life (odds ratio [OR]: 6.73; 95% confidence interval [CI]: 3.29, 13.78) and dying in a city other than the city of usual residence (OR: 4.68, 95% CI: 2.56, 8.57). Factors associated with home death were not having health care coverage (OR: 2.78, 95% CI: 1.34, 5.88), living in a city of less than 100,000 residents (OR: 2.44, 95% CI: 1.43, 4.17), and older age (OR: 1.03, 95% CI: 1.01, 1.05). Conclusion: Older Mexicans with access to health care services were more likely to die in the hospital even after controlling for important clinical and demographic characteristics. Findings from the study may be used to plan the provision of accessible end-of-life hospital and home-based services.
KW - Access to health care
KW - Mexico
KW - aging
KW - palliative care
KW - place of death
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U2 - 10.1016/j.jpainsymman.2010.07.007
DO - 10.1016/j.jpainsymman.2010.07.007
M3 - Article
C2 - 21146354
AN - SCOPUS:79955699275
SN - 0885-3924
VL - 41
SP - 880
EP - 892
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 5
ER -