Cork city dwellers more likely to die in hospital

Categories: Research.

People living in Cork city are more likely to die in a busy acute hospital than people living in Cork County, a study revealed.

The in-county variation in the proportion of people who die in acute hospitals is revealed in an Irish Hospice Foundation report.

The study shows that almost half of deaths recorded in Cork city occur in acute hospitals. But only two out of five deaths of people from Cork County – 39 per cent – occurred in busy acute hospitals.

Almost a third of deaths recorded in Cork County occurred at home compared to one in four in Cork City. But the proportion of people who died in a hospice was almost twice as high for people living in the city compared to Cork County.

The research paper: Enabling More People to Die at Home does not give a definite reason for the in-county variation.

But it speculates that availability of alternatives to hospital care – including supports in the home and alternatives like long-stay facilities in community hospitals and nursing homes – may play a factor in the differences.

The report claims the findings make a case for the introduction of a Key performance Indicators for the health service which aims to reduce deaths in hospitals.

Three out of four people surveyed in a recent national IHF poll said they would like to die at home.  However the number of people who die at home in Ireland has continually dropped over the last century, according to the report.

Eight out ten people die at home in 1885. But the proportion of deaths at home had dropped to 60 per cent by the 1950s. About one in four deaths recorded at the moment occur at home.

Over the same period the number of deaths in hospitals and institutions has risen. Now about seven out of ten people who die in Ireland every year die in a hospital or nursing home.

Irish Hospice Foundation chairperson Jean McKiernan said most people in Ireland say they want to die at home. She said it is a simple vision yet in the last 60 years it has become rarer and harder to achieve.

She said: “The IHF recognises that there are a myriad of factors that influence whether a person can die at home. As we age, and as illness progresses, preferences may of course, change. But people in Ireland consistently and increasingly say that they want to die at home.

“This can and should become the norm for those who choose it. The fact that quality homecare services at the end-of-life may be cost-neutral or even cost-effective for the health service would be an added bonus,” she said.

IHF chief executive Sharon Foley said the IHF fervently believes that ensuring people can fulfil the wish to die at home is a mark of a civilised, person-centred and  caring society.

About 29,000 people die in Ireland every year. The research highlights the wide difference in home deaths across the country, with only 18% of people in Dublin dying at home compared to 34% in Donegal.

The report, supported by a paper written by social and economic research consultant Dr. Kieran McKeown, draws on data published by the CSO which shows people living in Donegal are more likely to die at home (34%), followed by Kilkenny and Kerry, (33%), Mayo, (32%), and Leitrim and Wexford, (31%).However only 18% of people in Dublin die at home, followed by Sligo next, (26%), and Roscommon and Galway, (26%), which is the national average.

http://hospicefoundation.ie/wp-content/uploads/2014/12/Enabling-More-People-to-Die-at-Home1.pdf

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