The places of death of cancer patients over time Analysis of death certificates for the years 2001, 2011 and 2017

Background In the modern hospice and palliative movement, the preferred place of death is considered a quality indicator for appropriate care of dying people. Cancer patients represent the largest group of people receiving hospice and palliative care. Objective The aim of the study was to describe the places of death of oncological patients over a 16-year observation period (2001-2017). Materials and methods All death certificates of selected Westphalian regions (cities Bochum and Munster, districts Borken and Coesfeld) of the years 2001, 2011, 2017 were analysed. Cancer patients (ICD-10, C00-C97) were identified based on the medical information provided by the physician regarding the cause of death. Results A total of 38,954 death certificates were evaluated. Malignant cancer was present in 32.2% of the deceased (95% confidence interval [CI] 31.4-33.0%; 12,531). Age-standardised frequencies of places of death (2001, 2001, 2017, in %): at home: 24.7, 24.9, 21.5; hospital (total): 61.5, 51.0, 51.2 (palliative care unit: 0.0, 2.2, 16.1; other places of death in hospital: 61.5, 48.8, 35.1); hospice 5.5, 12.5, 15.0; nursing home: 8.2, 11.2, 12.0; other place: 0.1, 0.3, 0.3. Conclusion More than half of the deceased cancer patients died in hospital. Only every fourth to fifth death took place in the home environment. The trend over time (2001-2017) shows that cancer patients die less frequently at home and in hospitals, but more frequently in palliative care units, hospices and nursing homes.