RT Journal Article
SR Electronic
T1 Deaths from heart failure and cancer: location trends
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP e736
OP e742
DO 10.1136/bmjspcare-2020-002275
VO 14
IS e1
A1 Shahid, Izza
A1 Kumar, Pankaj
A1 Khan, Muhammad Shahzeb
A1 Arif, Abdul Wahab
A1 Farooq, Muhammad Zain
A1 Khan, Safi U
A1 Davis, Dorothy M
A1 Michos, Erin D
A1 Krasuski, Richard A
YR 2024
UL http://spcare.bmj.com/content/14/e1/e736.abstract
AB Background Increasing utilisation of hospice services has been a major focus in oncology, while only recently have cardiologists realised the similar needs of dying patients with heart failure (HF). We examined recent trends in locations of deaths in these two patient populations to gain further insight.Methods Complete population-level data were obtained from the Mortality Multiple Cause-of-Death Public Use Record from the National Center for Health Statistics database, from 2013 to 2017. Location of death was categorised as hospital, home, hospice facility or nursing facility. Demographic characteristics evaluated by place of death included age, sex, race, ethnicity, marital status and education, and a multivariable logistic regression analysis was performed to analyse possible associations.Results Among 2 780 715 deaths from cancer, 27% occurred in-hospital and 14% in nursing facilities; while among 335 350 HF deaths, 27% occurred in-hospital and 30% in nursing facilities. Deaths occurred at hospice facilities in 14% of patients with cancer, compared with just 8.7% in HF (p=0.001). For both patients with HF and cancer, the proportion of at-home and in-hospice deaths increased significantly over time, with majority of deaths occurring at home. In both cancer and HF, patients of non-Hispanic ethnicity (cancer: OR 1.29, (1.27 to 1.31), HF: OR 1.14, (1.07 to 1.22)) and those with some college education (cancer: OR 1.10, (1.09 to 1.11); HF: OR 1.06, (1.04 to 1.09)) were significantly more likely to die in hospice.Conclusion Deaths in hospital or nursing facilities still account for nearly half of cancer or HF deaths. Although positive trends were seen with utilisation of hospice facilities in both groups, usage remains low and much remains to be achieved in both patient populations.Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information. Data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (https://wonder.cdc.gov/), which includes death certificate data from 2001 to 2017, for all deaths occurring in the United States. Individual level data from 1 January 2013 to 31 December 2017 were obtained from the Mortality Multiple Cause-of-Death Public Use Record for 2013-2017 from the National Center for Health Statistics (NCHS) (https://www.cdc.gov/nchs/nvss/mortality_public_use_data.htm) Since this is publicly available data, no conditions of reuse (e.g licence, embargo) apply.