Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data
Abstract Background Most care-dependent people live at home, where they also would prefer to die. Unfortunately, this wish is often not fulfilled. This study aims to investigate place of death of home care recipients, taking characteristics and changes in care settings into account. Methods We retro...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-022-01060-w |
| _version_ | 1797996136659681280 |
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| author | Rieke Schnakenberg Alexander Maximilian Fassmer Katharina Allers Falk Hoffmann |
| author_facet | Rieke Schnakenberg Alexander Maximilian Fassmer Katharina Allers Falk Hoffmann |
| author_sort | Rieke Schnakenberg |
| collection | DOAJ |
| description | Abstract Background Most care-dependent people live at home, where they also would prefer to die. Unfortunately, this wish is often not fulfilled. This study aims to investigate place of death of home care recipients, taking characteristics and changes in care settings into account. Methods We retrospectively analysed a cohort of all home-care receiving people of a German statutory health insurance who were at least 65 years and who deceased between January 2016 and June 2019. Next to the care need, duration of care, age, sex, and disease, care setting at death and place of death were considered. We examined the characteristics by place of care, the proportion of dying in hospital by care setting and characterised the deceased cohort stratified by their actual place of death. Results Of 46,207 care-dependent people initially receiving home care, 57.5% died within 3.5 years (n = 26,590; mean age: 86.8; 66.6% female). More than half of those moved to another care setting before death with long-term nursing home care (32.3%) and short-term nursing home care (11.7%) being the most frequent transitions, while 48.1% were still cared for at home. Overall, 36.9% died in hospital and in-hospital deaths were found most often in those still receiving home care (44.7%) as well as care in semi-residential arrangements (43.9%) at the time of death. People who died in hospital were younger (mean age: 85.5 years) and with lower care dependency (low care need: 28.2%) as in all other analysed care settings. Conclusion In Germany, changes in care settings before death occur often. The proportion of in-hospital death is particularly high in the home setting and in semi-residential arrangements. These settings should be considered in interventions aiming to decrease the number of unwished care transitions and hospitalisations at the end of life. |
| first_indexed | 2024-04-11T10:11:39Z |
| format | Article |
| id | doaj.art-440cf20f97f94988a6aaddaaaaf5e319 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-11T10:11:39Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-440cf20f97f94988a6aaddaaaaf5e3192022-12-22T04:30:04ZengBMCBMC Palliative Care1472-684X2022-10-012111810.1186/s12904-022-01060-wCharacteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims dataRieke Schnakenberg0Alexander Maximilian Fassmer1Katharina Allers2Falk Hoffmann3Faculty of Medicine and Health Siences, Department of Health Services Research, Carl von Ossietzky University of OldenburgFaculty of Medicine and Health Siences, Department of Health Services Research, Carl von Ossietzky University of OldenburgFaculty of Medicine and Health Siences, Department of Health Services Research, Carl von Ossietzky University of OldenburgFaculty of Medicine and Health Siences, Department of Health Services Research, Carl von Ossietzky University of OldenburgAbstract Background Most care-dependent people live at home, where they also would prefer to die. Unfortunately, this wish is often not fulfilled. This study aims to investigate place of death of home care recipients, taking characteristics and changes in care settings into account. Methods We retrospectively analysed a cohort of all home-care receiving people of a German statutory health insurance who were at least 65 years and who deceased between January 2016 and June 2019. Next to the care need, duration of care, age, sex, and disease, care setting at death and place of death were considered. We examined the characteristics by place of care, the proportion of dying in hospital by care setting and characterised the deceased cohort stratified by their actual place of death. Results Of 46,207 care-dependent people initially receiving home care, 57.5% died within 3.5 years (n = 26,590; mean age: 86.8; 66.6% female). More than half of those moved to another care setting before death with long-term nursing home care (32.3%) and short-term nursing home care (11.7%) being the most frequent transitions, while 48.1% were still cared for at home. Overall, 36.9% died in hospital and in-hospital deaths were found most often in those still receiving home care (44.7%) as well as care in semi-residential arrangements (43.9%) at the time of death. People who died in hospital were younger (mean age: 85.5 years) and with lower care dependency (low care need: 28.2%) as in all other analysed care settings. Conclusion In Germany, changes in care settings before death occur often. The proportion of in-hospital death is particularly high in the home setting and in semi-residential arrangements. These settings should be considered in interventions aiming to decrease the number of unwished care transitions and hospitalisations at the end of life.https://doi.org/10.1186/s12904-022-01060-wHome care recipientsGerman health insurance claims-dataCare settingsPlace of death |
| spellingShingle | Rieke Schnakenberg Alexander Maximilian Fassmer Katharina Allers Falk Hoffmann Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data BMC Palliative Care Home care recipients German health insurance claims-data Care settings Place of death |
| title | Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data |
| title_full | Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data |
| title_fullStr | Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data |
| title_full_unstemmed | Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data |
| title_short | Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data |
| title_sort | characteristics and place of death in home care recipients in germany an analysis of nationwide health insurance claims data |
| topic | Home care recipients German health insurance claims-data Care settings Place of death |
| url | https://doi.org/10.1186/s12904-022-01060-w |
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