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Palliative care
Research
Likelihood of death among hospital inpatients in New Zealand: prevalent cohort study
  1. Merryn Gott1,
  2. Joanna Broad2,
  3. Xian Zhang2,
  4. Lene Jarlbaek3,
  5. David Clark4
  1. 1 The School of Nursing, The University of Auckland, Auckland, New Zealand
  2. 2 Freemasons Department of Geriatric Medicine, The University of Auckland, Auckland, New Zealand
  3. 3 Department of Clinical Research, The Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Odense, Denmark
  4. 4 School of Interdisciplinary Studies, University of Glasgow, Glasgow, UK
  1. Correspondence to Professor Merryn Gott; m.gott{at}auckland.ac.nz

Abstract

Objectives (1) To establish the likelihood of dying within 12 months for a cohort of hospital inpatients in New Zealand (NZ) on a fixed census date; (2) to identify associations between likelihood of death and key sociodemographic, diagnostic and service-related factors and (3) to compare results with, and extend findings of, a Scottish study undertaken for the same time period and census date. National databases of hospitalisations and death registrations were used, linked by unique health identifier.

Participants 6074 patients stayed overnight in NZ hospitals on the census date (10 April 2013), 40.8% of whom were aged ≥65 years; 54.4% were women; 69.1% of patients were NZ European; 15.3% were Maori; 7.6% were Pacific; 6.1% were Asian and 1.9% were ‘other’.

Setting All NZ hospitals.

Results 14.5% patients (n=878) had died within 12 months: 1.6% by 7 days; 4.5% by 30 days; 8.0% by 3 months and 10.9% by 6 months. In logistic regression models, the strongest predictors of death within 12 months were: age ≥80 years (OR=5.52(95% CI 4.31 to 7.07)); a history of cancer (OR=4.20(3.53 to 4.98)); being Māori (OR=1.62(1.25 to 2.10)) and being admitted to a medical specialty, compared with a surgical specialty (OR=3.16(2.66 to 3.76)).

Conclusion While hospitals are an important site of end of life care in NZ, their role is less significant than in Scotland, where 30% of an inpatient cohort recruited using similar methods and undertaken on the same census date had died within 12 months. One reason for this finding may be the extended role of residential long-term care facilities in end of life care provision in NZ.

  • palliative care
  • end of life
  • hospital
  • ethnicity
  • mortality
  • death

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-016880

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    Footnotes

    • Contributors MG, made a substantial contribution to study design and interpretation, drafted the majority of the paper and revised following coauthor feedback, and acts as guarantor for the paper. JB, made a substantial contribution to study design and interpretation, led the analysis, had input into the paper and approved the final version. XZ, contributed to study design, undertook the analysis, and reviewed and approved the final paper. LJ and DC, contributed to study design and interpretation, provided input into the paper, and approved the final version.

    • Competing interests None declared.

    • Ethics approval University of Auckland Human Participants Ethics Committee (ref: 02/11/2015).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Access to data analysed for the purposes of this study is via the NZ Ministry of Health.