Place of death and associated factors in 12 Latin American countries: A total population study using death certificate data.


Journal

Journal of global health
ISSN: 2047-2986
Titre abrégé: J Glob Health
Pays: Scotland
ID NLM: 101578780

Informations de publication

Date de publication:
30 Apr 2022
Historique:
entrez: 29 4 2022
pubmed: 30 4 2022
medline: 4 5 2022
Statut: epublish

Résumé

Little is known about place of death in Latin America, although this data are crucial for health system planning. This study aims to describe place of death and associated factors in Latin America and to identify factors that contribute to inter-country differences in place of death. We conducted a total population observational study using death certificates of the total annual decedent populations in 12 countries (Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Ecuador, Mexico, Paraguay, Peru, and Uruguay) for the most recent available year (2016, 2017, or 2018). Data were analysed regarding place of death and multivariable logistic regression with place of death as the dependent variable was used to examine associated clinical and sociodemographic factors (independent variables) in each of the countries. The total study sample was 2 994 685 deaths; 31.3% of deaths occurred at home, and 57.6% in hospitals. A strong variation was found among the countries with home deaths ranging from 20% (Brazil) to 67.9% (Guatemala) and hospital deaths from 22.3% (Guatemala) to 69.5% (Argentina). These differences between countries remained largely unchanged after controlling for sociodemographic factors and causes of death. The likelihood of dying at home was consistently higher with increasing age, for those living in a rural area, and for those with a lower educational level (except in Argentina). Most deaths in Latin America occur in hospitals, with a strong variation between countries. As clinical and sociodemographic factors included in this study did not explain country differences, other factors such as policy and health care system seem to have a crucial impact on where people die in Latin America.

Sections du résumé

Background UNASSIGNED
Little is known about place of death in Latin America, although this data are crucial for health system planning. This study aims to describe place of death and associated factors in Latin America and to identify factors that contribute to inter-country differences in place of death.
Methods UNASSIGNED
We conducted a total population observational study using death certificates of the total annual decedent populations in 12 countries (Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Guatemala, Ecuador, Mexico, Paraguay, Peru, and Uruguay) for the most recent available year (2016, 2017, or 2018). Data were analysed regarding place of death and multivariable logistic regression with place of death as the dependent variable was used to examine associated clinical and sociodemographic factors (independent variables) in each of the countries.
Results UNASSIGNED
The total study sample was 2 994 685 deaths; 31.3% of deaths occurred at home, and 57.6% in hospitals. A strong variation was found among the countries with home deaths ranging from 20% (Brazil) to 67.9% (Guatemala) and hospital deaths from 22.3% (Guatemala) to 69.5% (Argentina). These differences between countries remained largely unchanged after controlling for sociodemographic factors and causes of death. The likelihood of dying at home was consistently higher with increasing age, for those living in a rural area, and for those with a lower educational level (except in Argentina).
Conclusions UNASSIGNED
Most deaths in Latin America occur in hospitals, with a strong variation between countries. As clinical and sociodemographic factors included in this study did not explain country differences, other factors such as policy and health care system seem to have a crucial impact on where people die in Latin America.

Identifiants

pubmed: 35486804
doi: 10.7189/jogh.12.04031
pmc: PMC9078151
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

04031

Informations de copyright

Copyright © 2022 by the Journal of Global Health. All rights reserved.

Déclaration de conflit d'intérêts

Competing interests: The authors completed the ICMJE Unified Competing Interest Form (available upon request from the corresponding author) and declare no conflicts of interest.

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Auteurs

Katja Seitz (K)

Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany.

Joachim Cohen (J)

End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.

Luc Deliens (L)

End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.

Andrea Cartin (A)

Universidad de Costa Rica, San José, Costa Rica.

Celina Castañeda de la Lanza (C)

Coordination for Advance Directives and Palliative Care Program, Institute of Health of the State of Mexico, Ministry of Health of Mexico, Toluca, Mexico.

Emanuel A Cardozo (EA)

Dirección de Estadísticas en Información de Salud, National Ministry of Health, Buenos Aires, Argentina.

Fernando Ci Marcucci (FC)

Hospital Dr. Anísio Figueiredo, State Health Secretariat of Paraná, Londrina, Brazil.

Leticia Viana (L)

Department of Palliative Care and Pain, National Cancer Institute, Capiata, Paraguay.

Luís F Rodrigues (LF)

Palliative Care Unit, Barreto's Cancer Hospital, Barretos, Brazil.

Marvin Colorado (M)

Hospital Divina Providencia, San Salvador, El Salvador.

Victor R Samayoa (VR)

Palliative Care Unit, Institute of Cancerology, Guatemala City, Guatemala.

Vilma A Tripodoro (VA)

Department of Palliative Care, Institute of Medical Research A. Lanari, University of Buenos Aires, Buenos Aires, Argentina.

Ximena Pozo (X)

Palliative Care Unit, Hospital Comprehensive Care for the Elderly, Ministry of Public Health, Quito, Ecuador.

Tania Pastrana (T)

Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany.

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Classifications MeSH