2013年至2019年瑞典死亡地点的趋势--披露姑息治疗的先决条件。

IF 2.7 Q2 HEALTH CARE SCIENCES & SERVICES Palliative Care and Social Practice Pub Date : 2024-03-16 eCollection Date: 2024-01-01 DOI:10.1177/26323524241238232
Cecilia Larsdotter, Stina Nyblom, Hanna Gyllensten, Carl-Johan Furst, Anneli Ozanne, Ragnhild Hedman, Stefan Nilsson, Joakim Öhlén
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引用次数: 0

摘要

背景:家庭护理的发展对瑞典医疗保健系统的组织和资源分配产生了越来越大的影响:为了揭示姑息治疗的先决条件,本研究旨在调查2013年至2019年瑞典成年人口死亡地点的纵向趋势,并研究死亡地点与个人、地理和社会经济因素、医院能力以及医疗保健利用率之间的潜在关联:这项人口层面的综合登记研究包括所有年龄在 18 岁以下、登记有死亡地点的死者(n = 599,137 人)。数据取自公共和患者数据登记册以及国家姑息治疗登记册。通过逻辑回归和交互分析研究了死亡地点与共变量之间的趋势和关联:从 2013 年到 2019 年,在家中死亡的总人数增加了 1.9%,而在医院死亡的人数减少了 2.6%。从 2013 年到 2019 年,在自己家中居住的总体人群中,死于医院与死于家中的可能性均有所下降(几率比:0.98,95% 置信区间:0.97-0.99)。在有潜在姑息治疗需求的居家人群(78.4%)中,除斯德哥尔摩和北部地区外,死于医院的可能性同样有所下降。然而,对于居住在疗养院的人来说,在医院死亡与在疗养院直至死亡的可能性相比,只有南部地区显著下降:结果显示,住院死亡人数呈下降趋势,但各地区之间存在差异。但在 2019 年,只有约五分之一的人死在自己家中。建议采取以公共卫生为导向的干预措施,旨在加强养老院和家庭护理中的姑息关怀资源。
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Trends in the place of death in Sweden from 2013 to 2019 - disclosing prerequisites for palliative care.

Background: The drive for home care has increasingly impacted the organization and allocation of resources within the Swedish healthcare system.

Objectives: With an interest in uncovering prerequisites for palliative care, this study aimed to investigate longitudinal trends in place of death within the adult Swedish population from 2013 to 2019 and examine potential associations between place of death and individual, geographic, and socioeconomic factors; hospital capacity; and healthcare utilization.

Methods: This population-level comprehensive register study included all deceased individuals ⩾18 years old with a registered place of death (n = 599,137). Data were retrieved from public and patient data registers and the national register for palliative care. Trends and associations between place of death and co-variables were investigated by logistic regression- and interaction analyses.

Results: From 2013 to 2019, the total number of home deaths increased by 1.9%, whereas the number of hospital deaths decreased by 2.6%. In the overall population of individuals living in their own homes, from 2013 to 2019, the likelihood of dying in hospital versus dying at home decreased (odds ratio: 0.98, 95% confidence interval: 0.97-0.99). Within the population with potential palliative needs living in their own home (78.4%), the likelihood of dying in hospitals equally decreased, except in Stockholm and the north region. For individuals residing in a nursing home, however, the likelihood of dying in hospital versus remaining in the nursing home until death only significantly decreased in the southern region.

Conclusion: The results show a trend towards a decrease in hospital deaths but with cross-regional variations. Still, in 2019, only about one-fifth of all individuals died in their own homes. Public health-oriented interventions aimed at strengthening palliative care resources in nursing homes and home care are suggested.

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来源期刊
Palliative Care and Social Practice
Palliative Care and Social Practice Nursing-Advanced and Specialized Nursing
CiteScore
2.90
自引率
0.00%
发文量
37
审稿时长
9 weeks
期刊最新文献
Medical influence: what does success look like? Palliative care consultation in the last week of life and associated factors: a cross-sectional general population study. Using relational ethics to approach equity in palliative care. Fostering timely integrated palliative care in nursing homes through critical companionship: experiences from a Padi-Palli interventional study in France. Experience or perception: What healthcare providers need when using the Utrecht Symptom Diary-4 Dimensional, a mixed-methods study.
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