Place of death of children and young adults with a life-limiting condition in England: a retrospective cohort study

Abstract

Objective To assess trends in place of death for children with a life-limiting condition and the factors associated with death at home or hospice rather than hospital. Design Observational cohort study using linked routinely collected data. Setting England. Patients Children aged 0–25 years who died between 2003 and 2017. Main outcome measures Place of death: hospital, hospice, home. Multivariable multinomial logistic regression models. Results 39 349 children died: 73% occurred in hospital, 6% in hospice and 16% at home. In the multivariable models compared with dying in a hospital: neonates were less likely, and those aged 1–10 years more likely, than those aged 28 days to Conclusions Most children with a life-limiting condition continue to die in the hospital setting. Further research on preferences for place of death is needed especially in children with conditions other than cancer. Paediatric palliative care services should be funded adequately to enable equal access across all settings, diagnostic groups and geographical regions.