Context: Home-based deaths are increasing, yet, how wealth influences where people die in the presence of disability remains unknown.
Objective: To examine place of death by help with (instrumental) activities of daily living (I/ADLs) at the end of life (EOL) and the modifying role of wealth.
Methods: Retrospective study of decedents from the Health and Retirement Study (n = 13,210). The exposure was intensity of help with I/ADLs at the EOL (no help/ lower intensity/higher intensity). The outcome was place of death (hospital/nursing home/home). Household wealth was an effect modifier with six categories: ≤$0, first-fifth quintile. Covariates included age, gender, race, marital status at the EOL, last place of residence, and receipt of hospice care. We used multinomial logit regression models with estimates reported as average marginal effects (AMEs).
Results: Mean age was 79.8 years; 53.2% were female. In the adjusted models, compared to not receiving help at EOL, receiving higher-intensity help was associated with a lower probability of dying in a hospital (AME = -3.8 percentage points (pp), 95% CI = -6.3 to -1.3) and a higher probability of dying at home (AME = 3.6 pp, 95% CI = 1.4-5.7). Associations were most pronounced among decedents in the top two wealth quintiles; older adults who received higher-intensity help had a lower probability of dying in a hospital (AME = -9.0 pp, 95% CI = -14.8 to -3.1), and a higher probability of dying at home (AME = 8.4 pp, 95% CI = 3.8-13.0).
Conclusion: Receiving higher intensity of help with I/ADLs was associated with lower likelihood of dying in a hospital, and higher likelihood of dying at home, particularly among older adults with greater wealth.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jpainsymman.2024.02.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Characteristics of patients who die in an acute palliative care unit.
Support Care Cancer
December 2024
Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90127, Palermo, Italy.
Aim: To evaluate the characteristics of patients with advanced cancer who die in an acute palliative care unit (APCU), and the risk factors for death in APCU.
Methods: Adult consecutive patients with advanced cancer admitted to the APCU in a period of 13 months were prospectively assessed. At APCU admission, epidemiologic data, characteristics of admission, cachexia, being on-off anticancer treatment, and Edmonton Symptom Assessment System (ESAS) and MDAS (Memorial Delirium Assessment Scale) were assessed.
White blood cell-to-haemoglobin ratio as a predictor of 30-day mortality in ICU patients with pulmonary hypertension: a MIMIC-IV database study.
BMC Cardiovasc Disord
December 2024
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Henan University of Science and Technology, Luoyang, Henan, China.
Background And Objective: The white blood cell-to-haemoglobin ratio (WHR) is a comprehensive indicator of inflammation and anaemia status. However, the relationship between the WHR and the risk of 30-day mortality among intensive care unit (ICU) patients with pulmonary hypertension (PH) remains unclear. The purpose of this study was to investigate the association between the WHR and 30-day mortality in critically ill patients with PH.
View Article and Find Full Text PDFEstimates of life expectancy and premature mortality among multidimensional poor and non-poor in India.
BMC Public Health
December 2024
Department of Population and Development, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India.
Background: In Low and Middle Income Countries (LMICs), reduction of multidimensional poverty and the increase in longevity are concomitant. Although a number of studies have estimated multidimensional poverty, studies on estimates of life expectancy and pre-mature mortality by multidimensional poverty are limited. We estimated life expectancy and premature mortality among multidimensionally poor and multidimensionally non-poor in India.
View Article and Find Full Text PDFIg-M and Ig-A Enriched Ig-G Infusion as Adjuvant Therapy in the Critically ill Patients Experiencing SARS-CoV-2 Severe Infection.
J Intensive Care Med
December 2024
Department of Anaesthesiology, Pain Medicine and Perioperative Care, University of Washington, Seattle, Washington, USA.
Introduction: SARS-CoV-2 in patients who need Intensive Care (ICU) is associated with a mortality rate ranging from 10 to 40%-45%, with an increase in morbidity and mortality in presence of sepsis.
Methods: We assumed that immunoglobulin (Ig) M and IgA enriched IgG (IGAM) therapy may support SARS COV-2 sepsis-related phase improving patient outcome. We conducted a retrospective case-control study on all the patients admitted to our ICU during the three pandemic waves between February 2020 and April 2021.
Childhood mortality due to pneumonia; evidence from a tertiary paediatric referral center in Sri Lanka.
BMC Public Health
December 2024
Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Background: Pneumonia is a major cause responsible for mortality and morbidity among children around the world. The present study aimed to determine the age distribution, and contributing risk factors for mortality among children who died from pneumonia.
Method: This study was a cross-sectional study conducted at Teaching Hospital Peradeniya and Sirimavo Bandaranaike Specialized Children's Hospital (SBSCH) which is one of the two specialised children's hospitals in the country.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!