文章基本信息

标题：Why Did an Out-of-Hospital Shift of Death and Dying Occur in Canada after 1994?
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作者：Donna M. Wilson ; Jessica A. Hewitt ; Roger E. Thomas 等
期刊名称：International Journal of Palliative Care
印刷版ISSN：2356-7074
电子版ISSN：2314-579X
出版年度：2014
卷号：2014
DOI：10.1155/2014/157536
出版社：Hindawi Publishing Corporation
摘要：Canadian population mortality data reveal a significantly reduced proportion of deaths occurring in hospitals after 1994. Hospital deaths peaked at 80.5% in 1994, after a longstanding hospitalization-of-death trend in Canada. A decline in hospital-based death and dying has also occurred in some other countries. As the place of death can have multiple significant direct and indirect impacts on dying individuals, their families, and health services utilization and costs, it is important to understand factors for an out-of-hospital shift. An integrative review of Canadian print literature from 1995 was undertaken to identify these factors, with three themes emerging: (1) changes in health care and health system reforms after 1994 reduced both the availability and desirability of hospital-based care, (2) sociodemographic developments including aging of the population, increased multiculturalism, and diversity in accepted end-of-life care practices shifted place preferences, and (3) advances in palliative and end-of-life care, including a palliative care expansion out of hospital, supported nonhospital death, and dying processes. The period following 1994 was thus a time of major transformation during which the place of death and dying underwent important changes that supported and promoted a transition from hospital-based end-of-life care.