Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey

Anna E Bone; Wei Gao; Barbara Gomes; Katherine E Sleeman; Matthew Maddocks; Juliet Wright; Deokhee Yi; Irene J Higginson; Catherine J Evans; OPTCare Elderly

doi:10.1111/jgs.14442

Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey

Anna E Bone, Wei Gao, Barbara Gomes, Katherine E Sleeman, Matthew Maddocks, Juliet Wright, Deokhee Yi, Irene J Higginson, Catherine J Evans, OPTCare Elderly

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

Research output: Contribution to journal › Article › peer-review

31 Citations (Scopus)

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Abstract

OBJECTIVES: To identify factors associated with end-of-life (EoL) transition from usual place of care to the hospital as place of death for people aged 75 and older.

DESIGN: Population-based mortality follow-back survey.

SETTING: Deaths over 6 months in 2012 in two unitary authorities in England covering 800 square miles with more than 1 million residents.

PARTICIPANTS: A random sample of people aged 75 and older who died in a care home or hospital and all those who died at home or in a hospice unit (N = 882). Cases were identified from death registrations. The person who registered the death (a relative for 98.9%) completed the survey.

MEASUREMENTS: The main outcome was EoL transition to the hospital as place of death versus no EoL transition to the hospital. Multivariable modified Poisson regression was used to examine factors (illness, demographic, environmental) related to EoL transition to the hospital.

RESULTS: Four hundred forty-three (50.2%) individuals responded, describing the care of the people who died. Most died from nonmalignant conditions (76.3%) at a mean age of 87.4 ± 6.4. One hundred forty-six (32.3%) transitioned to the hospital and died there. Transition was more likely for individuals with respiratory disease than for those with cancer (prevalence ratio (PR) = 2.07, 95% confidence interval (CI) = 1.42-3.01) and for people with severe breathlessness (PR = 1.96, 95% CI = 1.12-3.43). Transition was less likely if EoL preferences had been discussed with a healthcare professional (PR = 0.60, 95% CI = 0.42-0.88) and when there was a key healthcare professional (PR = 0.74, 95% CI = 0.58-0.95).

CONCLUSION: To reduce EoL transition to the hospital for older people, there needs to be improved management of breathlessness in the community and better access to a key healthcare professional skilled in coordinating care, communication, facilitating complex discussions, and in planning for future care.

Original language	English
Pages (from-to)	2210-2217
Number of pages	8
Journal	Journal of the American Geriatrics Society
Volume	64
Issue number	11
Early online date	9 Sept 2016
DOIs	https://doi.org/10.1111/jgs.14442 https://doi.org/10.1111/jgs.14442 https://doi.org/10.1111/jgs.14442
Publication status	Published - 16 Nov 2016

Keywords

Frail Elderly
Palliative care
Terminal care
Cross-sectional survey
Mortality follow-back survey

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Factors Associated with Transition_BONE_Online 9Sept2016_GOLD VoRFinal published version, 147 KBLicence: CC BY

Cite this

Bone, A. E., Gao, W., Gomes, B., Sleeman, K. E., Maddocks, M., Wright, J., Yi, D., Higginson, I. J., Evans, C. J., & OPTCare Elderly (2016). Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey. Journal of the American Geriatrics Society, 64(11), 2210-2217. https://doi.org/10.1111/jgs.14442, https://doi.org/10.1111/jgs.14442, https://doi.org/10.1111/jgs.14442

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title = "Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey",

abstract = "OBJECTIVES: To identify factors associated with end-of-life (EoL) transition from usual place of care to the hospital as place of death for people aged 75 and older.DESIGN: Population-based mortality follow-back survey.SETTING: Deaths over 6 months in 2012 in two unitary authorities in England covering 800 square miles with more than 1 million residents.PARTICIPANTS: A random sample of people aged 75 and older who died in a care home or hospital and all those who died at home or in a hospice unit (N = 882). Cases were identified from death registrations. The person who registered the death (a relative for 98.9%) completed the survey.MEASUREMENTS: The main outcome was EoL transition to the hospital as place of death versus no EoL transition to the hospital. Multivariable modified Poisson regression was used to examine factors (illness, demographic, environmental) related to EoL transition to the hospital.RESULTS: Four hundred forty-three (50.2%) individuals responded, describing the care of the people who died. Most died from nonmalignant conditions (76.3%) at a mean age of 87.4 ± 6.4. One hundred forty-six (32.3%) transitioned to the hospital and died there. Transition was more likely for individuals with respiratory disease than for those with cancer (prevalence ratio (PR) = 2.07, 95% confidence interval (CI) = 1.42-3.01) and for people with severe breathlessness (PR = 1.96, 95% CI = 1.12-3.43). Transition was less likely if EoL preferences had been discussed with a healthcare professional (PR = 0.60, 95% CI = 0.42-0.88) and when there was a key healthcare professional (PR = 0.74, 95% CI = 0.58-0.95).CONCLUSION: To reduce EoL transition to the hospital for older people, there needs to be improved management of breathlessness in the community and better access to a key healthcare professional skilled in coordinating care, communication, facilitating complex discussions, and in planning for future care.",

keywords = "Frail Elderly, Palliative care, Terminal care, Cross-sectional survey, Mortality follow-back survey",

author = "Bone, {Anna E} and Wei Gao and Barbara Gomes and Sleeman, {Katherine E} and Matthew Maddocks and Juliet Wright and Deokhee Yi and Higginson, {Irene J} and Evans, {Catherine J} and {OPTCare Elderly}",

note = "{\textcopyright} 2016, The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.",

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language = "English",

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Bone, AE , Gao, W , Gomes, B , Sleeman, KE , Maddocks, M, Wright, J, Yi, D , Higginson, IJ , Evans, CJ & OPTCare Elderly 2016, 'Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey', Journal of the American Geriatrics Society, vol. 64, no. 11, pp. 2210-2217. https://doi.org/10.1111/jgs.14442, https://doi.org/10.1111/jgs.14442, https://doi.org/10.1111/jgs.14442

Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey. / Bone, Anna E ; Gao, Wei ; Gomes, Barbara et al.
In: Journal of the American Geriatrics Society, Vol. 64, No. 11, 16.11.2016, p. 2210-2217.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older

T2 - A Population-Based Mortality Follow-Back Survey

AU - Bone, Anna E

AU - Gao, Wei

AU - Gomes, Barbara

AU - Sleeman, Katherine E

AU - Maddocks, Matthew

AU - Wright, Juliet

AU - Yi, Deokhee

AU - Higginson, Irene J

AU - Evans, Catherine J

AU - OPTCare Elderly

PY - 2016/11/16

Y1 - 2016/11/16

N2 - OBJECTIVES: To identify factors associated with end-of-life (EoL) transition from usual place of care to the hospital as place of death for people aged 75 and older.DESIGN: Population-based mortality follow-back survey.SETTING: Deaths over 6 months in 2012 in two unitary authorities in England covering 800 square miles with more than 1 million residents.PARTICIPANTS: A random sample of people aged 75 and older who died in a care home or hospital and all those who died at home or in a hospice unit (N = 882). Cases were identified from death registrations. The person who registered the death (a relative for 98.9%) completed the survey.MEASUREMENTS: The main outcome was EoL transition to the hospital as place of death versus no EoL transition to the hospital. Multivariable modified Poisson regression was used to examine factors (illness, demographic, environmental) related to EoL transition to the hospital.RESULTS: Four hundred forty-three (50.2%) individuals responded, describing the care of the people who died. Most died from nonmalignant conditions (76.3%) at a mean age of 87.4 ± 6.4. One hundred forty-six (32.3%) transitioned to the hospital and died there. Transition was more likely for individuals with respiratory disease than for those with cancer (prevalence ratio (PR) = 2.07, 95% confidence interval (CI) = 1.42-3.01) and for people with severe breathlessness (PR = 1.96, 95% CI = 1.12-3.43). Transition was less likely if EoL preferences had been discussed with a healthcare professional (PR = 0.60, 95% CI = 0.42-0.88) and when there was a key healthcare professional (PR = 0.74, 95% CI = 0.58-0.95).CONCLUSION: To reduce EoL transition to the hospital for older people, there needs to be improved management of breathlessness in the community and better access to a key healthcare professional skilled in coordinating care, communication, facilitating complex discussions, and in planning for future care.

AB - OBJECTIVES: To identify factors associated with end-of-life (EoL) transition from usual place of care to the hospital as place of death for people aged 75 and older.DESIGN: Population-based mortality follow-back survey.SETTING: Deaths over 6 months in 2012 in two unitary authorities in England covering 800 square miles with more than 1 million residents.PARTICIPANTS: A random sample of people aged 75 and older who died in a care home or hospital and all those who died at home or in a hospice unit (N = 882). Cases were identified from death registrations. The person who registered the death (a relative for 98.9%) completed the survey.MEASUREMENTS: The main outcome was EoL transition to the hospital as place of death versus no EoL transition to the hospital. Multivariable modified Poisson regression was used to examine factors (illness, demographic, environmental) related to EoL transition to the hospital.RESULTS: Four hundred forty-three (50.2%) individuals responded, describing the care of the people who died. Most died from nonmalignant conditions (76.3%) at a mean age of 87.4 ± 6.4. One hundred forty-six (32.3%) transitioned to the hospital and died there. Transition was more likely for individuals with respiratory disease than for those with cancer (prevalence ratio (PR) = 2.07, 95% confidence interval (CI) = 1.42-3.01) and for people with severe breathlessness (PR = 1.96, 95% CI = 1.12-3.43). Transition was less likely if EoL preferences had been discussed with a healthcare professional (PR = 0.60, 95% CI = 0.42-0.88) and when there was a key healthcare professional (PR = 0.74, 95% CI = 0.58-0.95).CONCLUSION: To reduce EoL transition to the hospital for older people, there needs to be improved management of breathlessness in the community and better access to a key healthcare professional skilled in coordinating care, communication, facilitating complex discussions, and in planning for future care.

KW - Frail Elderly

KW - Palliative care

KW - Terminal care

KW - Cross-sectional survey

KW - Mortality follow-back survey

U2 - 10.1111/jgs.14442

DO - 10.1111/jgs.14442

M3 - Article

C2 - 27610598

SN - 0002-8614

VL - 64

SP - 2210

EP - 2217

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

IS - 11

ER -

Bone AE , Gao W , Gomes B , Sleeman KE , Maddocks M, Wright J et al. Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey. Journal of the American Geriatrics Society. 2016 Nov 16;64(11):2210-2217. Epub 2016 Sept 9. doi: 10.1111/jgs.14442, 10.1111/jgs.14442, 10.1111/jgs.14442

Factors Associated with Transition from Community Settings to Hospital as Place of Death for Adults Aged 75 and Older: A Population-Based Mortality Follow-Back Survey

Abstract

Keywords

UN SDGs

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