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Place of death in Parkinson’s disease: trends in the USA
  1. Pankaj Kumar1,
  2. Farah Yasmin1,
  3. Muhammad Shahzeb Khan2,
  4. Izza Shahid3,
  5. Mufaddal Najmuddin Diwan1,
  6. Richard E Leiter4,5,6 and
  7. Haider J Warraich6,7,8
  1. 1Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
  2. 2Department of Cardiovascular Medicine, Duke University Hospital, Durham, North Carolina, USA
  3. 3Department of Internal Medicine, Ziauddin Medical University, Karachi, Pakistan
  4. 4Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  5. 5Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
  6. 6Harvard Medical School, Boston, Massachusetts, USA
  7. 7Department of Medicine, Cardiology Section, VA Boston Healthcare System, Boston, Massachusetts, USA
  8. 8Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Farah Yasmin, Dow University of Health Sciences, Karachi, Pakistan; farahyasmin972{at}yahoo.com

Abstract

Background Parkinson’s disease (PD) is a significant cause of mortality but little is known about the place of death for patients with PD in the USA, a key metric of end-of-life care.

Methodology A trend analysis was conducted for years 2003–2017 using aggregated death certificate data from the Centers for Disease Control and Prevention Wide-ranging OnLine Data for Epidemiologic Research) database, with individual-level mortality data from the Mortality Multiple Cause-of-Death Public Use Record available between 2013 and 2017. All natural deaths for which PD was identified as an underlying cause of death were identified. Place of death was categorised as hospital, decedent home, hospice facility, nursing home/long-term care and other.

Results Between 2003 and 2017, 346141 deaths were attributed to PD (59% males, 93.7% White). Most deaths occurred in patients aged 75–84 years (43.9%), followed by those aged ≥85 years (40.9 %). Hospital and nursing home deaths decreased from 18% (n=3240) and 52.6% (n=9474) in 2003 to 9.2% (n=2949) and 42% (n=13 429) in 2017, respectively. Home deaths increased from 21.1% (n=3804) to 32.4% (n=10 347) and hospice facility deaths increased from 0.3% (n=47) in 2003 to 8.6% (n=2739) in 2017. Female sex, being married and college education were associated with increased odds of home deaths while Hispanic ethnicity and non-white race were associated with increased odds of hospital deaths.

Conclusion Home and hospice facility deaths are gradually increasing in patients with PD. Particular attention should be provided to vulnerable socioeconomic groups that continue to have higher rates of hospital deaths and decreased usage of hospice facilities.

  • hospice care
  • quality of life
  • supportive care
  • neurological conditions

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Footnotes

  • Contributors PK: Conception of the study, major drafting of the work, final approval and agreeing to the accuracy of the work. FY: Conception of the study, major drafting of the work, final approval and agreeing to the accuracy of the work. MSK: Conception of the study, major drafting of the work, final approval and agreeing to the accuracy of the work. IS: Help in design of the study, major drafting of the work, final approval and agreeing to the accuracy of the work. MND: Help in design of the study, major drafting of the work, final approval and agreeing to the accuracy of the work. RL: Supervision, critical revision of the manuscript, final approval and agreeing to the accuracy of the work. HW: Supervision, critical revision of the manuscript, final approval and agreeing to the accuracy of the work.

  • 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.

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

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