Where people die (1974-2030): past trends, future projections and implications for care
Where people die (1974-2030): past trends, future projections and implications for care
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DOI：
10.1177/0269216307084606
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发表时间：
2008-01-01
影响因子：
4.4
通讯作者：
Higginson, Irene J.
中科院分区：
文献类型：
--
作者：
Gomes, Barbara;Higginson, Irene J.
背景：老龄化国家对临终关怀的需求不断增长，但这些需求从未被详细预测过。我们分析了过去的死亡地点趋势（1974-2003 年），并根据这些护理需求预测了英格兰和威尔士到 2030 年的可能趋势。方法：死亡率趋势和预测来自官方统计数据。使用年龄和性别特定家庭死亡比例的最近五年趋势对未来情景进行建模，以估计到 2030 年按地点划分的死亡人数，并考虑到死亡年龄和性别分布的未来变化。结果：从 1974 年到 2003 年，每年的死亡人数下降了 8%，但预计从 2012 年到 2030 年将上升 17%。人们的死亡年龄将越来越大，其中 85 岁老年人的死亡比例预计将从 2003 年的 32% 上升到 2030 年的 44%。家庭死亡比例总体上从 31% 下降到 18%，而且比率更高。 65 岁及以上人群、女性和非癌症死亡。如果最近的趋势继续下去，到 2030 年，家庭死亡人数可能会减少 42%，不到十分之一的人会在家中死亡。到 2030 年，每年机构死亡人数（目前为 440936 人）将达到 530409 人（增加 20%）。结论：在英格兰和威尔士，家庭死亡人数一直在下降。这些预测强调了迫切需要规划护理以适应老龄化和死亡人数的大幅增加。要么住院设施必须大幅增加，要么从 2012 年起会有更多的人需要社区临终关怀。
Background: Ageing nations have growing needs for end of life care, but these have never been projected in detail. We analysed past trends in place of death (1974-2003) and projected likely trends to 2030 in England and Wales and from these need for care. Methods: Mortality trends and forecasts were obtained from official statistics. Future scenarios were modelled using recent five-year trends in age and gender specific home death proportions to estimate numbers of deaths by place to 2030, accounting for future changes in the age and gender distribution of deaths. Results: Annual numbers of deaths fell by 8% from 1974 to 2003, but are expected to rise by 17% from 2012 to 2030. People will die increasingly at older ages, with the percentage of deaths among those aged 85 and expected to rise from 32% in 2003 to 44% in 2030. Home death proportions fell from 31 % to 18% overall, and at an even higher rate for people aged 65 and over, women and noncancer deaths. If recent trends continue, numbers of home deaths could reduce by 42% and fewer than 1 in 10 will die at home in 2030. Annual numbers of institutional deaths (currently 440936) will be 530409 by 2030 (20% increase). Conclusions: In England and Wales home deaths have been decreasing. The projections underline the urgent need for planning care to accommodate a large increase of ageing and deaths. Either inpatient facilities must increase substantially, or many more people will need community end of life care from 2012 onwards.