Where People Die: A Multilevel Approach to Understanding Influences on Site of Death in America
| Autor: | Jason Roy, Joan M. Teno, Andrea Gruneir, Vincent Mor, Sherry Weitzen, Rachael Truchil |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Gerontology
Attitude to Death Cross-sectional study media_common.quotation_subject Empirical Research Death Certificates 03 medical and health sciences Social support 0302 clinical medicine Patient satisfaction Residence Characteristics 030502 gerontology Humans Terminally Ill Medicine Demography Probability media_common business.industry Health Policy Multilevel model Social Support Payment Home Care Services Hospitals United States Educational attainment Nursing Homes Cross-Sectional Studies Systematic review Patient Satisfaction 030220 oncology & carcinogenesis 0305 other medical science business Medicaid |
| Zdroj: | Medical Care Research and Review. 64:351-378 |
| ISSN: | 1552-6801 1077-5587 |
| DOI: | 10.1177/1077558707301810 |
| Popis: | Despite documented preferences for home death, the majority of deaths from terminal illness occur in hospital. To better understand variation in place of death, we conducted a systematic literature review and a multilevel analysis in which we linked death certificates with county and state data. The results of both components revealed that opportunities for home death are disproportionately found in certain groups of Americans; more specifically, those who are White, have greater access to resources and social support, and die of cancer. From the multilevel analysis, the higher the proportion minority and the lower the level of educational attainment, the higher the probability of hospital death while investment in institutional long-term care, measured by regional density of nursing home beds and state Medicaid payment rate, was associated with higher probability of nursing home death. These results reinforce the importance of both social and structural characteristics in shaping the end-of-life experience. |
| Databáze: | OpenAIRE |
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