Where people die in Victoria

Objective:To describe where deaths occur in Victoria and to determine to what extent the probability of dying in certain institutions is associated with cause of death and socio‐demographic variables. Design:Descriptive study of death certificates and multivariate analysis of 7697 deaths that occurred in a three‐month period in 1988. Setting:The State of Victoria. Main outcome measures:Cause of death, age, sex, marital status, and socioeconomic status. Results:Most deaths occurred in public hospitals (48%) followed by private homes (21%), nursing homes (14%) and private hospitals (9%). Only 2% of all deaths (90% from cancer) occurred in hospices. Women were more likely to die in a nursing home than were men (21 % v. 8%) and less likely to die at home (17% v. 24%). The proportion of deaths increased with age in nursing homes and declined in private homes. Significant predictors of death in a public hospital were age and socioeconomic status; the probability diminished with increasing age and was lower for those in the upper third for socioeconomic status. Predictors for dying in a private home were age and marital status; the probability diminished with age and in the absence of a spouse. Conclusions:Death as a hospice inpatient is comparatively rare in Victoria and the impart of hospice outpatient or domiciliary care on dying at home has yet to be established. Should death at home become a preferred option, the presence and ability of a spouse or other caregiver will be a significant factor.