Where do we draw our last breath? A comparative analysis of factors associated with places of death in European countries

Leonarda Srdelic

doi:10.59954/stnv.629

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Published: Oct 15, 2024

DOI: https://doi.org/10.59954/stnv.629

Keywords:

ageing, end-of-life care, long-term care, place of death, SHARE

Leonarda Srdelic

Institute of Public Finance, Zagreb (Croatia)

https://orcid.org/0000-0002-4079-8198

Abstract

This paper investigates whether a shift towards formal long-term care (LTC), typically associated with increased public spending in LTC, correlates with a lower likelihood of dying in hospitals compared to homes or care homes. Additionally, the study aims to assess how demographic, socioeconomic, and health-related variables are associated with the place of death across European countries. For this purpose, the study employs multinomial logistic regression on the data concerning 16,633 individuals aged 50 and over, who died between 2004 and 2021 in 24 European countries. The countries are grouped in two country groups to control for variations in their LTC systems. The first group consists of countries with more generous public funding for LTC, while the second group includes those where LTC is less funded and structured. Results indicate that the place of death is associated with the country’s healthcare system, demographic characteristics, socioeconomic status, and medical conditions. While hospitals remain the most common setting for death, this trend is shifting as recent years have seen a rise in deaths at home or in care homes across both country groups.

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Srdelic, L. (2024). Where do we draw our last breath? A comparative analysis of factors associated with places of death in European countries. Stanovnistvo. https://doi.org/10.59954/stnv.629

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Online First

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Articles

Published by the Institute of Social Sciences - Center for Demographic Research

Author Biography

Leonarda Srdelic, Institute of Public Finance, Zagreb (Croatia)

Senior research assistant

References

Bauer, J. M., & Sousa-Poza, A. (2015). Impacts of Informal Caregiving on Caregiver Employment, Health, and Family. Population Ageing, 8, 113–145. https://doi.org/10.1007/s12062-015-9116-0 DOI: https://doi.org/10.1007/s12062-015-9116-0

Börsch-Supan, A., Brandt, M., Hunkler, C., Kneip, T., Korbmacher, J., Malter, F., … Zuber, S. (2013). Data resource profile: The survey of health, ageing and retirement in Europe (SHARE). International Journal of Epidemiology, 42(4), 992–1001. https://doi.org/10.1093/ije/dyt088 DOI: https://doi.org/10.1093/ije/dyt088

Carmichael, F., & Charles, S. (2003). The opportunity costs of informal care: does gender matter? Journal of Health Economics, 22 (5), 781-803. https://doi.org/10.1016/S0167-6296(03)00044-4 DOI: https://doi.org/10.1016/S0167-6296(03)00044-4

Cohen, J., Bilsen, J., Fischer, S., Löfmark, R., Norup, M., van der Heide, A., … Deliens, L. (2007). End-of-life decision-making in Belgium, Denmark, Sweden and Switzerland: Does place of death make a difference? Journal of Epidemiology and Community Health, 61(12), 1062-1068. https://doi.org/10.1136/jech.2006.056341 DOI: https://doi.org/10.1136/jech.2006.056341

Cohen, J., & Deliens, L. (Ed.). (2012). A public health perspective on end-of-life care. Oxford: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199599400.001.0001 DOI: https://doi.org/10.1093/acprof:oso/9780199599400.001.0001

Costa-Font, J., & Courbage, C. (Ed.). (2012). Financing Long-Term Care in Europe: Institutions, Markets and Models. New York: Palgrave Macmillan. DOI: https://doi.org/10.1057/9780230349193

Costa-Font, J., Jimenez-Martin, S., & Vilaplana, C. (2018). Does long-term care subsidisation reduce hospital admissions and utilisation? Journal of Health Economics, 58, 43-66. https://doi.org/10.1016/j.jhealeco.2018.01.002 DOI: https://doi.org/10.1016/j.jhealeco.2018.01.002

Courbage, C., & Eeckhoudt, L. (2012). On insuring and caring for parents’ long-term care needs. Journal of Health Economics, 31(6), 842-850. https://doi.org/10.1016/j.jhealeco.2012.08.001 DOI: https://doi.org/10.1016/j.jhealeco.2012.08.001

Do, Y. K., Norton, E. C., Stearns, S. C., & Van Houtven, C. H. (2015). Informal care and caregiver’s health. Health Economics, 24(2), 224-237. https://doi.org/10.1002/hec.3012 DOI: https://doi.org/10.1002/hec.3012

Eurostat (2023). Causes of death statistics. https://doi.org/10.2908/HLTH_CD_ARO

Gill, A., Laporte, A., & Coyte, P. C. (2018). Predictors of home death in palliative care patients: A critical literature review. Journal of Palliative Care, 29(2), 113–118. https://doi.org/10.1177/082585971302900208 DOI: https://doi.org/10.1177/082585971302900208

Greene, W. H. (2018). Econometric Analysis (8th ed.) London: Pearson.

Hartwig, J. (2008). What drives health care expenditure? Baumol’s model of’ unbalanced growth’ revisited. Journal of Health Economics, 27(3), 603–23. https://doi.org/10.1016/j.jhealeco.2007.05.006 DOI: https://doi.org/10.1016/j.jhealeco.2007.05.006

Hoverman, J. R., Mann, B. B., Phu, S., Nelson, P., Hayes, J. E., Taniguchi, C. B., & Neubauer, M. A. (2020). Hospice or hospital: The costs of dying of cancer in the oncology care model. Palliative Medicine Reports, 1(1), 92–96. https://doi.org/10.1089/pmr.2020.0023 DOI: https://doi.org/10.1089/pmr.2020.0023

Howdon, D., & Rice, N. (2018). Health care expenditures, age, proximity to death and morbidity: Implications for an ageing population. Journal of Health Economics, 57, 60–74. https://doi.org/10.1016/j.jhealeco.2017.11.001 DOI: https://doi.org/10.1016/j.jhealeco.2017.11.001

Katz, S. (1983). Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. Journal of the American Geriatrics Society, 31(12), 721–727. https://doi.org/10.1111/j.1532-5415.1983.tb03391.x DOI: https://doi.org/10.1111/j.1532-5415.1983.tb03391.x

Ko, M.-C., Huang, S.-J., Chen, C.-C., Chang, Y.-P., Lien, H.-Y., Lin, J.-Y., … Chan, S.-Y. (2017). Factors predicting a home death among home palliative care recipients. Medicine (Baltimore), 96(41), e8210. https://doi.org/10.1097/MD.0000000000008210 DOI: https://doi.org/10.1097/MD.0000000000008210

Lin, C.-P., Tsay, M.-S., Chang, Y.-H., Chen, H.-C., Wang, C.-Y., Chuang, Y.-S., & Wu, C.-Y. (2021). A comparison of the survival, place of death, and medical utilization of terminal patients receiving hospital-based and community-based palliative home care: A retrospective and propensity score matching cohort study. International Journal of Environmental Research and Public Health, 18(14), 7272. https://doi.org/10.3390/ijerph18147272 DOI: https://doi.org/10.3390/ijerph18147272

Lysaght, S., & Ersek, M. (2013). Settings of care within hospice: New options and questions about dying "at home." Journal of Hospice & Palliative Nursing, 15(3), 171–176. https://doi.org/10.1097/NJH.0b013e3182765a17 DOI: https://doi.org/10.1097/NJH.0b013e3182765a17

Norton, E. (2000). Long-term care. In A. J. Culyer, & J. P. Newhouse (Eds.), Handbooks of Health Economics (pp. 955-994). Amsterdam: North Holland. http://dx.doi.org/10.1016/S1574-0064(00)80030-X DOI: https://doi.org/10.1016/S1574-0064(00)80030-X

OECD (2017). Health at a Glance 2017: OECD Indicators. Paris: OECD Publishing

https://doi.org/10.1787/health_glance-2017-en DOI: https://doi.org/10.1787/health_glance-2017-en

OECD (2023). Health at a Glance 2023: OECD Indicators. Paris: OECD Publishing https://doi.org/10.1787/7a7afb35-en DOI: https://doi.org/10.1787/7a7afb35-en

Orlovic, M., Marti, J., & Mossialos, E. (2017). Analysis Of End-Of-Life Care, Out-Of-Pocket Spending, And Place Of Death In 16 European Countries And Israel. Health Affairs, 36(7), 1201-1210. https://doi.org/10.1377/hlthaff.2017.0166 DOI: https://doi.org/10.1377/hlthaff.2017.0166

Pivodic, L., Pardon, K., Morin, L., Addington-Hall, J., Miccinesi, G., Cardenas-Turanzas, M., … Cohen, J. (2015). Place of death in the population dying from diseases indicative of palliative care need: A cross-national population-level study in 14 countries. Journal of Epidemiology and Community Health, 70(1), 17-24. https://doi.org/10.1136/jech-2014-205365 DOI: https://doi.org/10.1136/jech-2014-205365

Ranci, C., & Pavolini, E. (Eds.). (2013). Reforms in Long-Term Care Policies in Europe: Investigating Institutional Change and Social Impacts. New York: Springer. https://link.springer.com/book/10.1007/978-1-4614-4502-9 DOI: https://doi.org/10.1007/978-1-4614-4502-9

Rosenthal, C. J., Martin-Matthews, A., & Matthews, S. H. (1996). Caught in the Middle? Occupancy in Multiple Roles and Help to Parents in a National Probability Sample of Canadian Adults. Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 51(6), S274-S283. https://doi.org/10.1093/geronb/51b.6.s274 DOI: https://doi.org/10.1093/geronb/51B.6.S274

Spasova, S., Baeten, R., Coster, S., Ghailani, D., Peña-Casas, R., & Vanhercke, B. (2018). Challenges in long-term care in Europe: A study of national policies. European Social Policy Network (ESPN), Brussels: European Commission.

Srdelić, L., & Smolić, S. (2022). Factors associated with place of death: evidence from older adults in 24 European countries. SHARE Working Paper Series 83-2022, preprint. https://doi.org/10.17617/2.3477442

Washington, K. T., Pike, K. C., Demiris, G., Parker Oliver, D., Albright, D. L., & Lewis, A. M. (2015). Gender differences in caregiving at end of life: Implications for hospice teams. Journal of Palliative Medicine, 18(12), 1048–1053. https://doi.org/10.1089/jpm.2015.0214 DOI: https://doi.org/10.1089/jpm.2015.0214

Weaver, R. H., Roberto, K. A., & Brossoie, N. (2020). A scoping review: Characteristics and outcomes of residents who experience involuntary relocation. The Gerontologist, 60(1), e20–e37. https://doi.org/10.1093/geront/gnz035 DOI: https://doi.org/10.1093/geront/gnz035

Wong, A. D., & Phillips, S. P. (2023). Gender disparities in end of life care: A scoping review. Journal of Palliative Care, 38(1), 78–96. https://doi.org/10.1177/08258597221120707 DOI: https://doi.org/10.1177/08258597221120707

Yang, Z., Norton, E. C., & Stearns, S. C. (2003). Longevity and Health Care Expenditures: The Real Reasons Older People Spend More. The Journals of Gerontology Series B, 58(1), S2–S10. https://doi.org/10.1093/geronb/58.1.s2 DOI: https://doi.org/10.1093/geronb/58.1.S2

Zweifel, P., Felder, S., & Meiers, M. (1999). Ageing of population and health care expenditure: a red herring? Health Economics, 8(6), 485–496. https://doi.org/10.1002/(sici)1099-1050(199909)8:6<485::aid-hec461>3.0.co;2-4 DOI: https://doi.org/10.1002/(SICI)1099-1050(199909)8:6<485::AID-HEC461>3.0.CO;2-4

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Leonarda Srdelic, Institute of Public Finance, Zagreb (Croatia)

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