Place of death and phenomenon of going home to die in Chinese adults: a prospective cohort study

Weng, L; Hu, Y; Sun, Z; Yang, L; Chen, Y; Du, H; Pang, Y; Chen, Z

Journal article

Place of death and phenomenon of going home to die in Chinese adults: a prospective cohort study

Abstract:: Background: China is embracing an ageing population without sustainable end-of-life care services. However, changes in place of death and trends of going home to die (GHTD) from the hospital remains unknown.

strong>Methods: A total of 42,956 participants from the China Kadoorie Biobank, a large Chinese cohort, who died between 2009 and 2017 was included into analysis. GHTD was defined as death at home within 7 days after discharge from the hospital. A modified Poisson regression was used to investigate temporal trends of the place of death and GHTD, and estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association of GHTD with health insurance (HI) schemes.

Findings: From 2009 to 2017, home remained the most common place of death (71·5%), followed by the hospital (21·6%). The proportion of GHTD for Urban and Rural Residents’ Basic Medical Insurance (URRBMI) beneficiaries was around six times higher than that for Urban Employee Basic Medical Insurance (UEBMI) beneficiaries (66·0% vs 11·6%). Besides, a substantial increase in the proportion of GHTD throughout the study period was observed regardless of HI schemes (4·4% annually for URRBMI, and 5·4% for UEBMI). Compared with UEBMI beneficiaries, URRBMI beneficiaries were more likely to experience GHTD, with an adjusted PR (95% CI) of 1·19 (95% CI: 1·12, 1·27) (P<0·001).

Interpretation: In China, most of deaths occurred at home, with a large proportion of decedents GHTD from the hospital, especially for URRBMI beneficiaries. Substantial variation in the phenomenon of GHTD across HI schemes indicates inequalities in end-of-life care utilization.

Funding: The National Natural Science Foundation of China, the Kadoorie Charitable Foundation, the National Key R&D Program of China, the Chinese Ministry of Science and Technology.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Weng, L., Hu, Y., Sun, Z., Yang, L., Chen, Y., Du, H., Pang, Y., & Chen, Z. (2021). Place of death and phenomenon of going home to die in Chinese adults: a prospective cohort study. Lancet Regional Health Western Pacific, 18.

MLA Style

Weng, L, et al. “Place of Death and Phenomenon of Going Home to Die in Chinese Adults: a Prospective Cohort Study.” Lancet Regional Health Western Pacific, vol. 18, 2021.

Chicago Style

Weng, L, Y Hu, Z Sun, et al. 2021. “Place of Death and Phenomenon of Going Home to Die in Chinese Adults: a Prospective Cohort Study.” Lancet Regional Health Western Pacific 18.
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