Where and How Centenarians Die? The Role of Hospice Care

Am J Hosp Palliat Care. 2019 Dec;36(12):1068-1075. doi: 10.1177/1049909119845884. Epub 2019 Apr 29.

Abstract

The effect of hospice care on place of death among centenarians remained unexplored. Using data obtained from National Health Insurance Research Database (2002-2010), we compared the differences in place and cause of death between centenarians and noncentenarians. These data were stratified into centenarian (n = 2495) and noncentenarian (n = 820 563) death. Data in place and cause of death and hospice care interventions were retrieved. Poisson regression models were used to evaluate factors associated with the centenarians' place of death. Time series models were used to predict the number of centenarian deaths until 2025. Most (63.8%) of the centenarians died at their own homes, followed by 30.5% who died in hospital. Hospice home care was involved in only 0.3% of the centenarian deaths but in 1.8% of the noncentenarian deaths. The leading causes of death among centenarians were respiratory diseases (16.6%), circulatory diseases (15.2%), and pneumonia (14.8%). Among the centenarians, those who died of circulatory disease, old age, and respiratory diseases were more likely to die at their own homes. We forecasted the number of annual centenarian deaths to reach 800 in 2025. Therefore, an increase in the provision of advanced care planning and earlier home hospice care intervention may enable centenarians to die at their own residence.

Keywords: cause of death; centenarians; end-of-life care; hospice care; place of death.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over / statistics & numerical data*
  • Cause of Death
  • Death*
  • Female
  • Home Care Services / statistics & numerical data
  • Hospice Care / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Sex Factors
  • Taiwan