Lugar de muerte en Chile: un estudio poblacional con análisis de factores determinantes y tendencias entre 1990-2014

Resumen

Background: Unjustified transferences to hospitals are a serious problem that must be avoided when facing end of life care, especially in terminally ill patients. Aim: To study the place of death in Chile and its evolution from 1990 to 2014. Material and methods: Review of death records databases available at the Ministry of Health website. The place of death in those records is defined as hospital, home or other. This information was cross referenced with the age and diagnosis at death. A temporal series analysis was also done to assess the behavior of variables across time. Results: We analyzed 2,063,615 deaths. Of these, 898,871 (44%) occurred at the hospital. Subjects aged more than 85 have a higher odd of dying out of the hospital (odds ratio (OR) 2.52 95% confidence intervals (CI) 2.49-2.55). the same happens with people dying of cancer (OR 2.43 95%CI 2.42-2.45). There was no time related trend in place of death changes in the whole population. However, among subjects aged over 85 years the proportion of deaths at the hospital increased from 27% in 1990 to 32% in 2014. There are significantly different proportion of hospital deaths in different Chilean regions. Conclusions: The proportion of deaths occurring at the hospital are increasing among people aged 85 years or more.