Cargando…

Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer

Around a third of people with cancer will die outside of their preferred place of death, with substantial variation occurring between and within countries in terms of place of death. Here, we examine place of death within the New Zealand cancer context, with specific focus on differences between Ind...

Descripción completa

Detalles Bibliográficos
Autores principales: Gurney, Jason Kevin, Stanley, James, Koea, Jonathan, Adler, Jonathan, Atkinson, June, Sarfati, Diana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225597/
https://www.ncbi.nlm.nih.gov/pubmed/35623019
http://dx.doi.org/10.1200/GO.22.00024
_version_ 1784733655230316544
author Gurney, Jason Kevin
Stanley, James
Koea, Jonathan
Adler, Jonathan
Atkinson, June
Sarfati, Diana
author_facet Gurney, Jason Kevin
Stanley, James
Koea, Jonathan
Adler, Jonathan
Atkinson, June
Sarfati, Diana
author_sort Gurney, Jason Kevin
collection PubMed
description Around a third of people with cancer will die outside of their preferred place of death, with substantial variation occurring between and within countries in terms of place of death. Here, we examine place of death within the New Zealand cancer context, with specific focus on differences between Indigenous Māori and other ethnic groups. METHODS: Using national-level data, we identified all those who died in New Zealand between 2007 and 2018 of cancer (N = 107,373), stratified by ethnicity and cancer type, and linked these patients to national health and mortality records. We then described the crude and age-standardized proportions of cancer deaths by location separately by ethnic group, and conducted logistic regression to compare odds of death within a given location between ethnic groups. RESULTS: After adjusting for age, sex, and deprivation, we found that Māori people with cancer are more likely to die in a private residence than Europeans (46% v 26%; odds ratio [OR] 2.45; 95% CI, 2.36 to 2.55), and also somewhat more likely to die in hospital (27% v 23%; OR 1.26; 95% CI, 1.21 to 1.32). Commensurately, Māori are less likely to die in either hospice inpatient unit (14% v 27%; OR 0.48; 95% CI, 0.45 to 0.51) or residential care (12% v 30%; OR 0.56; 95% CI, 0.52 to 0.59). Pacific patients generally follow the same pattern as Māori patients. These findings were largely repeated across cancer types, with some variation in the magnitude not overall pattern. CONCLUSION: It remains unclear whether these differences reflect differences in preferences for place of death between ethnic groups, or whether they reflect differences in access to appropriate supportive care. Further research is required to examine these differences in greater detail.
format Online
Article
Text
id pubmed-9225597
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-92255972022-06-24 Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer Gurney, Jason Kevin Stanley, James Koea, Jonathan Adler, Jonathan Atkinson, June Sarfati, Diana JCO Glob Oncol ORIGINAL REPORTS Around a third of people with cancer will die outside of their preferred place of death, with substantial variation occurring between and within countries in terms of place of death. Here, we examine place of death within the New Zealand cancer context, with specific focus on differences between Indigenous Māori and other ethnic groups. METHODS: Using national-level data, we identified all those who died in New Zealand between 2007 and 2018 of cancer (N = 107,373), stratified by ethnicity and cancer type, and linked these patients to national health and mortality records. We then described the crude and age-standardized proportions of cancer deaths by location separately by ethnic group, and conducted logistic regression to compare odds of death within a given location between ethnic groups. RESULTS: After adjusting for age, sex, and deprivation, we found that Māori people with cancer are more likely to die in a private residence than Europeans (46% v 26%; odds ratio [OR] 2.45; 95% CI, 2.36 to 2.55), and also somewhat more likely to die in hospital (27% v 23%; OR 1.26; 95% CI, 1.21 to 1.32). Commensurately, Māori are less likely to die in either hospice inpatient unit (14% v 27%; OR 0.48; 95% CI, 0.45 to 0.51) or residential care (12% v 30%; OR 0.56; 95% CI, 0.52 to 0.59). Pacific patients generally follow the same pattern as Māori patients. These findings were largely repeated across cancer types, with some variation in the magnitude not overall pattern. CONCLUSION: It remains unclear whether these differences reflect differences in preferences for place of death between ethnic groups, or whether they reflect differences in access to appropriate supportive care. Further research is required to examine these differences in greater detail. Wolters Kluwer Health 2022-05-27 /pmc/articles/PMC9225597/ /pubmed/35623019 http://dx.doi.org/10.1200/GO.22.00024 Text en © 2022 by American Society of Clinical Oncology https://creativecommons.org/licenses/by-nc-nd/4.0/Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle ORIGINAL REPORTS
Gurney, Jason Kevin
Stanley, James
Koea, Jonathan
Adler, Jonathan
Atkinson, June
Sarfati, Diana
Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer
title Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer
title_full Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer
title_fullStr Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer
title_full_unstemmed Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer
title_short Where Are We Dying? Ethnic Differences in Place of Death Among New Zealanders Dying of Cancer
title_sort where are we dying? ethnic differences in place of death among new zealanders dying of cancer
topic ORIGINAL REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225597/
https://www.ncbi.nlm.nih.gov/pubmed/35623019
http://dx.doi.org/10.1200/GO.22.00024
work_keys_str_mv AT gurneyjasonkevin wherearewedyingethnicdifferencesinplaceofdeathamongnewzealandersdyingofcancer
AT stanleyjames wherearewedyingethnicdifferencesinplaceofdeathamongnewzealandersdyingofcancer
AT koeajonathan wherearewedyingethnicdifferencesinplaceofdeathamongnewzealandersdyingofcancer
AT adlerjonathan wherearewedyingethnicdifferencesinplaceofdeathamongnewzealandersdyingofcancer
AT atkinsonjune wherearewedyingethnicdifferencesinplaceofdeathamongnewzealandersdyingofcancer
AT sarfatidiana wherearewedyingethnicdifferencesinplaceofdeathamongnewzealandersdyingofcancer