Transferable deaths during 1990 for residents of Camberwell Health Authority.

Abstract

Almost one quarter of all deaths among residents of Camberwell District Health Authority during 1990 occurred without the district ('transferable deaths'). These deaths differed from total deaths in that the main cause of study deaths was cancer, and many of these cases died in a hospice with which the district has no direct contact. However, the commonest location of deaths was in hospitals (57% of study death locations) and the majority of these cases died in London teaching hospitals with whom there are major contracts. As the three inner London South East Thames districts, including Camberwell, propose to merge into a single purchasing authority in 1993, all London hospitals where Camberwell residents died in this survey would be covered by the current range of contracts set by the three districts. The study identified a small but important group of deaths from HIV/AIDS, where it seems that people travelled, particularly, to West London for terminal care. A high proportion of deaths from injury and poisoning were either suicides or open verdicts. There were less transferable deaths among the major ethnic minorities in the district than expected, particularly among those of African and Caribbean descent. This may be due to the age and disease patterns in these populations, but may also require study into the need for terminal care among these groups. Transferable deaths are a useful source of epidemiological information and can highlight local health service strengths and deficits.