Hospital and Patient Characteristics Regarding the Place of Death of Hospitalized Impending Death Patients: A Multilevel Analysis

Shin-Ting Yeh, Yee-Yung Ng and Shiao-Chi Wu
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Shin-Ting Yeh: College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11221, Taiwan
Yee-Yung Ng: Department of Medicine, School of Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, Taipei 24205, Taiwan
Shiao-Chi Wu: Institute of Health & Welfare Policy, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei 11221, Taiwan

IJERPH, 2019, vol. 16, issue 23, 1-9

Abstract: Objectives : To explore the influence of hospital and patient characteristics on deaths at home among inpatients facing impending death. Method: In this historical cohort study, 95,626 inpatients facing impending death from 362 hospitals in 2011 were recruited. The dependent variable was the place of death. The independent variables were the characteristics of the hospitals and the patients. A two-level hierarchical generalized linear model was used. Results: In total, 41.06% of subjects died at home. The hospital characteristics contributed to 29.25% of the total variation of the place of death. Private hospitals (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.00–1.75), patients >65 years old (OR = 1.48, 95% CI. = 1.42–1.54), married (OR = 3.15, 95% CI. = 2.93–3.40) or widowed (OR = 3.39, 95% CI. = 3.12–3.67), from near-poor households (OR = 5.16, 95% CI. = 4.57–5.84), having diabetes mellitus (OR = 1.79, 95% CI. = 1.65–1.94), and living in a subcounty (OR = 2.27, 95% CI. = 2.16–2.38) were all risk factors for a death at home. Conclusion: Both hospital and patient characteristics have an effect of deaths at home among inpatients facing impending death. The value of the inpatient mortality rate as a major index of hospital accreditation should be interpreted intrinsically with the rate of deaths at home.

Keywords: dying; place of death; population register; multilevel analysis; hospital mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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