Place of death in the adult portuguese population between 1980 and 2018

: a retrospective cohort study

Abstract

Introduction: Place of death has been extensively studied as a quality indicator of how people are cared for and achieving preferred place of death is seen as good access to health and palliative care. The aim of this study was to analyse the evolution of place of death in the adult Portuguese population from 1980 to 2018, according to different disease trajectories, discuss healthcare strategies that might correlate with the evolution of place of death in Portugal during this period and to analyse possible future changes in regards to palliative care access in Portugal due to population needs. Materials and Methods: This was an epidemiological, retrospective, analytic and observational study. Data for this study was obtained from Instituto Nacional de Estatística. Statistical analysis was made by calculating frequencies and percentages for place of death categories according to different disease trajectories and country regions. Joinpoint regression models were used to evaluate the tendency over time. Results: In Portugal, there were 2.635.291 deaths from 1980 to 2018 among the four different groups established in this study. Of these, 39.2% occurred at home,55.1% in hospital or clinic and 5.7% in other places. This study found an overall rising trend in deaths in the adult population in hospital or clinic and other places such as care or nursing homes, while deaths at home declined throughout the entire period analysed. Conclusions: Our findings suggest that there is further need for research not only on people’s preferences on where they would like to be cared for at the end of life, but also on understanding more deeply the impact of healthcare strategies already implemented and how to move forward to achieve good quality access to care and a good death.

Date of Award	4 Feb 2022
Original language	English
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Luís Capelas (Supervisor)