Place of Death and Its Determinants for Patients with Cancer in Singapore: An Analysis of Data from the Singapore Cancer Registry, 2000–2009
- 1 October 2011
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Palliative Medicine
- Vol. 14 (10), 1128-1134
- https://doi.org/10.1089/jpm.2011.0092
Abstract
Aims: To describe the place of death for patients with cancer in Singapore from 2000 to 2009, and determinants of death at home and in in-patient hospice compared to death in hospital. Method: Cross-sectional analysis of all patients registered with the Singapore Cancer Registry who had died in the study period (N=52120). Places of death were grouped as homes, in-patient hospices, hospitals and others. For determinants of death at home and in in-patient hospice, covariates adjusted for in logistic regression analyses were age group, gender, ethnic group, primary tumour site, stage at diagnosis, duration and cause of death. Results: In the 10-year period, 52.9% of patients with cancer had died in the hospital, 30.3% died at home and 10.7% in in-patient hospice. Determinants of death at home were older age, female (odds ratio OR 1.23, 95% confidence interval, CI 1.17-1.29), Malay (OR 2.28, 95% CI 2.13-2.44), cancers of the colo-rectum, liver, stomach, pancreas and nasopharynx (compared to lung cancer), duration of illness of 1-5 years (OR 1.40, 95% CI 1.34-1.48), primary cause of death being ‘neoplasms’ (OR 2.97, 95% CI 2.79-3.17). Determinants of death in in-patient hospice were older age, distant metastasis (OR 1.35, 95% CI 1.21-1.50) and primary cause of death being ‘neoplasms’ (OR 20.07, 95% CI 16.05-25.09). Conclusion: Knowledge about place of death and its determinants will facilitate the planning of healthcare services to enable patients with terminal cancer to die at home and in in-patient hospices, thereby avoiding inappropriate hospitalization at the end of life.Keywords
This publication has 20 references indexed in Scilit:
- Which Patients With Cancer Die at Home? A Study of Six European Countries Using Death Certificate DataJournal of Clinical Oncology, 2010
- Non-cancer mortality among long-term survivors of adult cancer in Korea: national cancer registry studyCancer Causes & Control, 2010
- Where Do Cancer Patients Die in Greece? A Population-Based Study on the Place of Death in 1993 and 2003Journal of Pain and Symptom Management, 2009
- Where people die (1974—2030): past trends, future projections and implications for carePalliative Medicine, 2008
- How is place of death from cancer changing and what affects it? Analysis of cancer registration and service dataBritish Journal of Cancer, 2006
- Factors influencing death at home in terminally ill patients with cancer: systematic reviewBMJ, 2006
- Place of death and access to home care services: are certain patient groups at a disadvantage?Social Science & Medicine, 1998
- Where do cancer patients die? Ten-year trends in the place of death of cancer patients in EnglandPalliative Medicine, 1998
- Worldwide trends in cancer mortality in the elderly, 1955–1992European Journal of Cancer, 1996
- Palliative home care and place of death among cancer patients: a population-based studyPalliative Medicine, 1993