Dying of cancer: Factors influencing the place of death of patients

Abstract

An analysis of factors influencing the place of death of patients seen by 2 medical oncology units is reported. There were 1295 recorded deaths of patients from the Royal Prince Alfred Hospital, Sydney [Australia], and 688 from the Royal North Shore Hospital of Sydney during 1979-1981; the places of death were known in 1724 instances (87%). Of these, 73% of patients died in hospital, 9% died in terminal nursing care (TNC) institutions and the remainder at home. Factors influencing the place of death were the place of residence, age, home circumstances.sbd.social support, diagnosis and interval from 1st contact with the medical oncology unit. A complex interrelation of these factors determines the place of death. Improvements in community services may allow more patients with cancer to die at home or in TNC institutions, but a substantial proportion of these will still die in major hospitals. Therefore, there is a need for the improvement of palliative care services in these institutions.