Epidemiological Study of Place of Death in Portugal in 2010 and Comparison with the Preferences of the Portuguese Population

Abstract

Introduction: In the context of a pronounced population ageing and rising mortality due to chronic illnesses, this national epidemiological study compares the places where people die with population preferences.
Material and Methods: Data on numbers of deaths in 2010 by gender, age group, region of residence NUTS II and place of death (hospital/clinic, domicile and other) of people with 16+ years old were provided by the Portuguese Statistics Institute. Data on population preferences for place of death were obtained in 2010 in the PRISMA telephone survey. The distribution of deaths by place of death is compared with population preferences, according to independent variables, using descriptive and inferential analysis.
Results: There were 105 471 deaths in Portugal in 2010. From these, 61.7% occurred at hospitals/clinics and 29.6% at the domicile. Of the 1 286 residents in Portugal that participated in the PRISMA survey, 51.2% chose home as preferred place of death, 35.7% chose a palliative care unit, 8.9% the hospital and 2.2% a nursing or residential home.
Discussion and Conclusion: There is a substantial gap between the reality and population preferences for place of death in Portugal. To better meet these preferences, it is a national priority to develop home palliative care services that prevent the rise of hospital deaths and that support death at home, with quality and whenever wished. It is recommended changing the coding of place of death in Portuguese death certificates, with inclusion of the options ‘palliative care unit’ and ‘nursing or residential home’, once citizens’ preferences clearly differentiate these places.