Socioeconomic Differences and Trends in the Place of Death among Elderly People in China.

Jiaoli Cai,Hongzhong Zhao,Peter Coyte

doi:10.3390/ijerph14101210

Abstract

China is facing a dramatic aging of its population. Little is known about the factors that influence the place of death and the trends in the place of death for elderly people in China. The purposes of this study were: (1) to examine the impact of the socioeconomic status (SES) on place of death for elderly Chinese residents; and (2) to assess temporal trends in the place of death over the last 15 years. Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998–2012). Place-of-death as an outcome was dichotomized into either death at home or death outside the home. Logistic regression analyses were used to examine the impact of SES on place of death. The results showed that, of the 23,098 deaths during the study period, 87.78% occurred at home. The overall trend in home death has increased since 2005. SES was shown to be an important factor affecting place of death. The elderly with higher SES were more likely to die where health resources were concentrated, i.e., in a hospital or other type of institution. Our finding suggests that the trend towards a greater emphasis on death at home may call for the development of more supportive home care programs in China. Our finding also suggests that the socioeconomic differences in the place of death may be related to the availability of or access to health care services.

Highlights

There has been a recent emphasis in the research literature on studies that assess the determinants of place of death [1,2,3,4,5,6,7]
The elderly who were Han nationality (OR, 0.51; 95% confidence intervals (CIs), 0.39–0.66) and from urban areas (OR, 0.35; 95% CI, 0.32–0.39) were less likely to die at home
We report that the overwhelming majority of elderly deaths in China occur at home and that there has been an increasing trend towards home deaths since 2005

Summary

Introduction

There has been a recent emphasis in the research literature on studies that assess the determinants of place of death [1,2,3,4,5,6,7]. An understanding of the factors that influence the place of death could better inform discussions among healthcare providers, patients and their families regarding patient preferences and the feasibility of dying in the preferred place [8]. This knowledge could inform policy decisions aimed at improving patients’ likelihood of dying in their preferred place of death [8]. Health care facilities may be improved and enhanced to support the increased home deaths if the trend in home death is increasing

Methods

Discussion

Conclusion