engleski

Factors associated with place of death: evidence from older adults in 24 European countries

Using the Survey of Health, Ageing and Retirement (SHARE) data for 16, 663 older adults who died between 2004 and 2021 in 24 European countries and with the help of multinomial logistic regression models, this study assesses the correspondence between the place of death and a set of demographic (age, gender), socio-economic (marital status, home ownership, no. of children) and health variables (cause of death, dependency status). We split the sample into two country groups based on the long-term care (LTC) expenditure and share of older adults who died in nursing homes in order to verify whether a shift to formal LTC (generally accompanied by higher public expenditure in LTC) is associated with (a) lower risk of dying at hospitals, compared to dying at home or in care homes and (b) higher risk of resorting to palliative care in last days of life. Our findings suggest that the place of death is partly influenced by individual factors and partly by the country-specific end-of-life care (EOLC) policies. Furthermore, there is evidence that the relative risk of dying in a care home compared to hospitals increases over time, signalling positive changes in the out-ofhospital EOLC. Our results suggest that proper out-of- hospital care may lower the number of hospitalisations, decrease the incidence of late and fatal hospitalisations, and lower the chances of in-hospital deaths. Moreover, an appropriate public policy should support both formal and informal forms of care to avoid discrimination against individuals living alone and thus ensure LTC becomes a fundamental right of citizens.

Ageing, End-of-life care, Long-term care, Place of death, SHARE

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