The National End of Life Care Programme in the UK has helped increase the proportion of cancer deaths that happen at home and in hospices, and reduce hospital deaths.
In a new study published in PLOS Medicine, researchers found that there has been an increase in the number of home and hospice deaths for people with cancer since 2005. They suggest that this is due to the work of the National End of Life Care Programme, which was established in 2004.
The researchers used death registration data from the Office of National Statistics to identify place of deaths for all the adult cancer deaths in England between 1993 and 2010. They then used this data to look at the changing pattern of place of death, and identify the factors that influenced place of death.
Over the period of the study, 48% of cancer deaths occurred in hospital, 24.5% at home, and 16.4% in hospices. The proportion of deaths at home and in a hospice increased from 2005, while the proportion of hospital deaths declined.
The research identifies cancer site, marital status and age as the three most important factors associated with place of death for patients with cancer – patients who died from haematological cancer, who were single, widowed or divorced or aged over 75 were less likely to die in home or hospice.
They also highlight a ‘worrying trend’ that shows that the differences between place of death for those who lived in advantaged and disadvantaged areas widened during 2001–2010.
The authors call for further efforts to reduce hospital deaths and increase home and hospice deaths. They suggest that people who are single, widowed or divorced should be a focus for end of life care improvement, along with known at risk groups such as haematological cancer, lung cancer, older age and deprivation.
The paper ‘Changing Patterns in Place of Cancer Death in England: A Population-Based Study’ by Wei Gao, Yuen K. Ho, Julia Verne, Myer Glickman and Irene J. Higginson was pubished in PLoS Med 10(3): e1001410. doi:10.1371/journal.pmed.1001410