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Factors associated with place of death for children in South Yorkshire: a retrospective cohort study
  1. Kate Renton1,
  2. Anton-Paul Thomas Mayer1,
  3. Lilias Alison2 and
  4. Daniel Yeomanson3
  1. 1 Paediatric Palliative Medicine, Sheffield Children’s NHS Foundation Trust, Sheffield, UK
  2. 2 Child Assessment Unit, Sheffield Children’s NHS Foundation Trust, Sheffield, UK
  3. 3 Paediatric Oncology, Sheffield Children’s NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Dr Kate Renton, Paediatric Palliative Medicine, Sheffield Children’s NHS Foundation Trust, Sheffield S10 2TH, UK; katerenton{at}nhs.net

Abstract

Objectives Place of death (POD) is considered a key quality indicator for adult end of-life care, but paediatric evidence is limited. Data from Child Death Overview Panel (CDOP) databases provides an opportunity to describe trends in POD as regional paediatric palliative medicine (PPM) options have increased. Aims were to identify and describe trends in POD for children in South Yorkshire.

Methods Retrospective cohort study. Anonymised data extracted from five CDOP databases 2008–2015. Data included age, gender, ethnicity, postcode (outward code only), POD, classification and category of death. Descriptive statistical analysis using χ2 test was used to assess intergroup differences.

Results 748 deaths were notified from 2008 to 2015. Neonatal deaths were excluded, 46% (n=345). Of non-neonatal deaths (n=403), 58% (n=232) were ‘expected’. Of expected deaths (n=232), 19% (n=45) died in home, 19% (n=45) died in hospice and 61% (n=141) died in hospital. This was significantly different from comparable national data which showed considerably more hospital deaths. There was no significant change in POD over time.

Conclusion Hospital remains the POD for most children, whether deaths are ‘expected’ or not, suggesting specialised PPM should be expanded into the hospital setting. More research is needed regarding preference for POD. This study may help inform future service planning for PPM and hospice development.

  • home care
  • hospice care
  • hospital care
  • paediatrics

https://doi.org/10.1136/bmjspcare-2018-001584

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    Footnotes

    • Contributors KR performed the literature search, contributed to study design and data collection, cleaned and analysed the data, drafted and revised the paper and is the guarantor. APTM and LA contributed to study design and revised the paper. DY is responsible for the original concept, supervised KR throughout all aspects and revised the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.