Trends in Place of Death in a Super-Aged Society: A Population-Based Study, 1998-2017
Trends in Place of Death in a Super-Aged Society: A Population-Based Study, 1998-2017
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DOI：
10.1089/jpm.2019.0445
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发表时间：
2020-02-18
影响因子：
2.8
通讯作者：
Kano, Mitsunobu R.
中科院分区：
文献类型：
--
作者：
Koyama, Toshihiro;Hagiya, Hideharu;Kano, Mitsunobu R.
背景：到2030年，全球死亡人数估计将增加到每年7 400万人。死亡地点（PoD）越来越被认为是临终关怀的一个重要方面。然而，在超老龄化社会之一的日本，PoD的最新趋势尚不清楚。目的：分析近二十年来日本PoD的趋势。设计：基于人群的回顾性观察研究。背景：1998-2017年日本报告的所有死亡病例。PoD被定义为医院、养老院或自己的家。结果：对过去20年日本所有死者（2260万人）进行了分析。医院死亡比例一直很高（80%），从2000年代中期开始有显著下降趋势。虽然在研究期间的前半段，在家死亡的比例有所下降，但后来又有所上升。与其他死亡地点相比，在养老院死亡的比例较低；然而，在整个研究期间，这一比例不断增加，特别是在妇女中。2015年，更多的女性死于疗养院而非家中。虽然医院死亡的比例在研究期间的后半段有所下降，但其总数继续增加，反映出日本总死亡人数的增加。结论：本研究突出了日本PoD趋势的快速变化，以及日本和其他人口老龄化国家考虑负担得起的临终关怀的必要性。这项长期流行病学研究的结果为这个问题提供了重要的见解。
Background: Globally, the number of deaths is estimated to increase to 74 million per year by 2030. Place of death (PoD) is increasingly being recognized as an important aspect of end-of-life care. However, recent trends in PoD in Japan, one of the super-aged societies, are unknown.Objective: To analyze trends in PoD in Japan over two decades.Design: Population-based retrospective observational study.Setting: All deaths reported in Japan, 1998-2017. PoD was defined as hospital, nursing home, or own home.Results: All Japanese decedents (similar to 22.6 million) over the past 20 years were analyzed. The proportion of hospital deaths was consistently high (>80%), with a significant decreasing trend from the mid-2000s. Although the proportion of deaths at home decreased in the first half of the study period, they later increased. There was a low proportion of deaths in nursing homes compared to other places of death; however, the proportion increased continually throughout the study period, particularly among women. In 2015, more women died in nursing homes than at home. Although the proportion of hospital deaths declined in the second half of the study period, their overall number continued to increase, reflecting an increase in total deaths in Japan.Conclusions: This study highlighted rapid changes in trends in PoD in Japan, and the need to consider affordable end-of-life care in Japan as well as other countries with aging populations. The findings from this long-term epidemiological study provide important insights on this issue.