Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 17;118(19):331-338.
doi: 10.3238/arztebl.m2021.0124.

Place of Death Trends and Utilization of Outpatient Palliative Care at the End of Life—Analysis of Death Certificates (2001, 2011, 2017) and Pseudonymized Data From Selected Palliative Medicine Consultation Services (2017) in Westphalia, Germany

Burkhard Dasch  1 , Peter K Zahn
Affiliations

Place of Death Trends and Utilization of Outpatient Palliative Care at the End of Life—Analysis of Death Certificates (2001, 2011, 2017) and Pseudonymized Data From Selected Palliative Medicine Consultation Services (2017) in Westphalia, Germany

Burkhard Dasch et al. Dtsch Arztebl Int. .

Abstract

Background: The largest German study on place of death was performed for deaths in selected regions of Westphalia in the years 2001 and 2011. In the period thereafter, provision of palliative care was regionally expanded. This upgrade included the establishment of palliative medicine consultation services (PMCS), combining general and specialized palliative care on an outpatient basis. A follow-up place of death survey took place in 2017. The aim was to depict the trends in place of death between 2001 and 2017. A second goal was to determine how often outpatient PMCS were used by persons who died in 2017.

Methods: Descriptive analysis of place of death as specified in all death certificates (2001, 2011, 2017) issued in the cities of Bochum and Münster and the districts of Borken and Coesfeld. Comparison of pseudonymized data on deceased patients (2017) treated by the PMCS of Münster and Coesfeld with the place of death database to ascertain the rate of PMCS care at the end of life.

Results: A total of 38 954 death certificates were analyzed, and 5887 deaths were compared with PCMS data. The distribution of place of death was as follows: (2001, 2011, 2017; age standardized; %): own residence 27.8; 23.3; 21.3; hospital: 55.8; 51.8; 51.8; palliative care unit: 0.0; 1.0; 6.2; hospice: 1.9; 4.5; 4.8; nursing home: 13.1; 18.6; 20.4; other: 1.2; 1.2; 1.5. The rate of PMCS use was 28.8% (1694/5887).

Conclusion: Over the period 2001-2017, the proportion of people who died at home or in the hospital went down, while the number who died in a palliative care unit, hospice, or nursing home increased. In the city of Münster and the district of Coesfeld, one fourth of the people who died in 2017 received PMCS care at the end of life.

PubMed Disclaimer

Figures

Figure 1a
Figure 1a
Distribution of place of death over time—stratified according to gender and age
Figure 1b
Figure 1b
Figure 2
Figure 2
Deaths 2017 (city of Münster and district of Coesfeld) with PMCS care—stratified according to age and place of death
eFigure
eFigure
Deaths 2017 (city of Münster and district of Coesfeld) with PMCS care—stratified according to gender, age and place of death
See this image and copyright information in PMC

References

    1. Statistisches Bundesamt (Destatis) Bevölkerung - Sterbefälle und Lebenserwartung. www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bevoelkerung/Sterbefaelle-... (last accessed on 20 December 2020)
    1. Deutscher Hospiz- und PalliativVerband e.V. (DHPV) Bevölkerungsbefragung „Sterben in Deutschland - Wissen und Einstellungen zum Sterben“ 2017. www.dhpv.de/service_forschung_detail/items/bevoelkerungsbefragung-sterbe... (last accessed on 20 December 2020)
    1. Billingham MJ, Billingham SJ. Congruence between preferred and actual place of death according to the presence of malignant or non-malignant disease: a systematic review and meta-analysis. BMJ Support Palliat Care. 2013;3:144–154. - PubMed
    1. Gomes B, Higginson IJ, Calanzani N. PRISMA: Preferences for place of death if faced with advanced cancer: a population survey in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. Ann Oncol. 2012;23:2006–2015. - PubMed
    1. Gomes B, Calanzani N, Gysels M, Hall S, Higginson IJ. Heterogeneity and changes in preferences for dying at home: a systematic review. BMC Palliat Care. 2013;12 - PMC - PubMed