The changing demographics of inpatient hospice death: Population-based cross-sectional study in England, 1993-2012

TY - JOUR

T1 - The changing demographics of inpatient hospice death

T2 - Population-based cross-sectional study in England, 1993-2012

AU - Sleeman, Katherine E

AU - Davies, Joanna M

AU - Verne, Julia

AU - Gao, Wei

AU - Higginson, Irene J

PY - 2016/1

Y1 - 2016/1

N2 - BACKGROUND: Studies in the United Kingdom and elsewhere have suggested inequality of hospice provision with respect to factors such as age, diagnosis and socio-economic position. How this has changed over time is unknown.AIM: To describe the factors associated with inpatient hospice death in England and examine how these have changed over time.DESIGN: Population-based study. Multivariable Poisson regression compared 1998-2002, 2003-2007 and 2008-2012, with 1993-1997. Explanatory variables included individual factors (age, gender, marital status, underlying cause of death) and area-based measures of deprivation.SETTING: Adults aged 25 years and over who died in inpatient hospice units in England between 1993 and 2002 (n = 446,615).RESULTS: The annual number of hospice deaths increased from 17,440 in 1993 to 26,032 in 2012, accounting for 3.4% of all deaths in 1993 and 6.0% in 2012. A total of 50.6% of hospice decedents were men; the mean age was 69.9 (standard deviation: 12.4) years. The likelihood of hospice decedents being in the oldest age group (>85 years) increased over time (proportion ratio: 1.43, 95% confidence interval: 1.39 to 1.48 for 2008-2012 compared to 1993-1997). Just 5.2% of all hospice decedents had non-cancer diagnoses, though the likelihood of non-cancer conditions increased over time (proportion ratio: 1.41, 95% confidence interval: 1.37 to 1.46 for 2008-2012 compared to 1993-1997). The likelihood of hospice decedents being resident in the least deprived quintile increased over time (proportion ratio: 1.25, 95% confidence interval: 1.22 to 1.29 for 2008-2012 compared to 1993-1997).CONCLUSION: The increase in non-cancer conditions among hospice decedents is encouraging although absolute numbers remain very small. Deprivation trends are concerning and require further exploration.

AB - BACKGROUND: Studies in the United Kingdom and elsewhere have suggested inequality of hospice provision with respect to factors such as age, diagnosis and socio-economic position. How this has changed over time is unknown.AIM: To describe the factors associated with inpatient hospice death in England and examine how these have changed over time.DESIGN: Population-based study. Multivariable Poisson regression compared 1998-2002, 2003-2007 and 2008-2012, with 1993-1997. Explanatory variables included individual factors (age, gender, marital status, underlying cause of death) and area-based measures of deprivation.SETTING: Adults aged 25 years and over who died in inpatient hospice units in England between 1993 and 2002 (n = 446,615).RESULTS: The annual number of hospice deaths increased from 17,440 in 1993 to 26,032 in 2012, accounting for 3.4% of all deaths in 1993 and 6.0% in 2012. A total of 50.6% of hospice decedents were men; the mean age was 69.9 (standard deviation: 12.4) years. The likelihood of hospice decedents being in the oldest age group (>85 years) increased over time (proportion ratio: 1.43, 95% confidence interval: 1.39 to 1.48 for 2008-2012 compared to 1993-1997). Just 5.2% of all hospice decedents had non-cancer diagnoses, though the likelihood of non-cancer conditions increased over time (proportion ratio: 1.41, 95% confidence interval: 1.37 to 1.46 for 2008-2012 compared to 1993-1997). The likelihood of hospice decedents being resident in the least deprived quintile increased over time (proportion ratio: 1.25, 95% confidence interval: 1.22 to 1.29 for 2008-2012 compared to 1993-1997).CONCLUSION: The increase in non-cancer conditions among hospice decedents is encouraging although absolute numbers remain very small. Deprivation trends are concerning and require further exploration.

U2 - 10.1177/0269216315585064

DO - 10.1177/0269216315585064

M3 - Article

C2 - 25991729

SN - 0269-2163

VL - 30

SP - 45

EP - 53

JO - Palliative Medicine

JF - Palliative Medicine

IS - 1

ER -