The
percentage of US deaths occurring in hospitals decreased by approximately 10%
from 2003 to 2017, according to findings from a study published in the New England Journal of Medicine.
This
study used data from the Centers for Disease Control and Prevention (CDC) and
the National Center for Health Statistics to evaluate the settings of natural
death — defined as death due to a medical condition — that occurred in the United
States from 2003 to 2017.
Of
the nearly 35.2 million natural deaths occurring during this time period,
29.3%, 24.5%, 10.5%, 7.9%, and 5.9% were attributed to cardiovascular disease,
cancer, respiratory disease, dementia, and stroke, respectively.
Although
39.7% of total natural deaths occurred in a hospital setting during 2003, this
percentage dropped to 29.8% in 2017. In contrast, deaths at home increased from
23.8% in 2003 to 30.7% in 2017.
“Home has surpassed the hospital as
the most common place of death in the [United States] for the first time since
the early 20th century,” the study authors noted.
Furthermore,
deaths while receiving hospice care increased from 0.2% in 2003 to 8.3% in 2017.
Although
these trends were observed across all disease groups, patients with cancer had
the highest odds of death at home and in hospice and the lowest odds of dying
in a nursing facility compared with patients with other causes of death.
Overall,
the odds of dying at home were lower for younger patients, female patients, and
racial/ethnic minorities compared with older patients, male patients, and white
patients.
The
study researchers commented that “the trends noted here represent progress; however,
more information about the experience of patients dying at home is needed to
develop policies and services that ensure high-quality end-of-life care. These
findings should lead to prioritizing improvements in access to high-quality
home care for older Americans with serious illnesses.”
Reference
Cross SH, Warraich HJ. Changes in the place of death in the United States. N Engl J Med. 2019;381(24):2369-2370.
This article originally appeared on Oncology Nurse Advisor