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Open Access Research article

Place of death in the Czech Republic and Slovakia: a population based comparative study using death certificates data

Martin Loucka*, Sheila A Payne, Sarah G Brearley and EURO IMPACT

Author Affiliations

The International Observatory on End-of-Life Care, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YG, UK

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BMC Palliative Care 2014, 13:13  doi:10.1186/1472-684X-13-13

Published: 20 March 2014

Abstract

Background

Place of death represents an important indicator for end-of-life care policy making and is related to the quality of life of patients and their families. The aim of the paper is to analyse the place of death in the Czech Republic and Slovakia in 2011. Research questions were focused on factors influencing the place of death and specifically the likelihood of dying at home.

Methods

Whole population data from death certificates for all deaths in the Czech Republic and Slovakia in 2011 were used for bivariate and multivariate analyses. Separate analysis using binary logistic regression was conducted for subpopulation of patients who died from chronic conditions.

Results

The majority of population in both countries died in hospitals (58.4% the Czech Republic, 54.8% Slovakia), less than one-third died at home. In case of chronic conditions, death at home was significantly associated with underlying cause of death (cancer and heart failure), being male, age (older than 85, Slovakia only) and higher education (the Czech Republic only). Cancer and heart failure patients had higher chances to die at home than other chronic conditions.

Conclusions

Czech and Slovak patients with chronic conditions are more likely to die in hospitals than in some other European Union member countries. This finding should be addressed by policy makers in promoting home hospice care services and education in palliative care for staff in nursing homes and other end-of-life settings.

Keywords:
Health policy; End-of-life care; Palliative care; Location of death; Eastern Europe