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Changes in the Place of Death in the United States
Open accessAbstract
n d e n c e Changes in the Place of Death in the United States To the Editor: Where people die is an impor tant determinant of patient and caregiver expe rience.To assess changes in place of death, we analyzed data from the Centers for Disease Control and Prevention and the National Center for Health Statistics database for natural deaths in the United States from 2003 through 2017.Cause of death was defined as the medical con dition that had started the events that led direct ly to death, as recorded by the physician on the death certificate. 1 Deaths from external causes were excluded.Between 2003 and 2017, there were nearly 35.2 million natural deaths (Fig. 1).Most were attributed to cardiovascular disease (29.3%), followed by cancer (24.5%), respiratory disease (10.5%), dementia (7.9%), and stroke (5.9%).In 2003, a total of 905,874 deaths occurred in hospitals (39.7%), which decreased to 764,424 (29.8%) in 2017, whereas the number of deaths at nursing facilities decreased from 538,817 (23.6%) to 534,714 (20.8%).The number of deaths at home increased from 543,874 (23.8%) in 2003 to 788,757 (30.7%) in 2017, whereas the number of deaths at hospice facilities increased from 5395 (0.2%) to 212,652 (8.3%).These trends were seen across all disease groups.Younger patients, female patients, and racial and ethnic minorities had lower odds of death at home than did older patients, male patients, and white patients.Patients with cancer had the greatest odds of death at home and death at a hospice facility and the lowest odds of death at a nursing facility relative to other conditions.Patients with dementia had the greatest odds of death at a nursing facility, and patients with re spiratory disease had the greatest odds of death at a hospital.Patients with stroke had the lowest odds of death at home, and patients with cardio
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“all cause mortality in US nursing homes had been decreasing until 2017.”
From Excess deaths associated with covid-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries (2021) · cites this paper as [68]
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“With the decreasing trend, the expected all cause mortality in 2020 would be lower than the 2017 estimates of 534 714 deaths.”
From Excess deaths associated with covid-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries (2021) · cites this paper as [68]
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- Where death lives now. In: Warraich H. Modern death: how medicine changed the end of life. New York: St. Martin’s Press/MacMillan, 2017:312.
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Metadata
- Authors
- Cross, S. H., & Warraich, H. J.
- Affiliations
- Duke University (US)
- VA Boston Healthcare System (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2019-12-12
- Volume
- 381
- Issue
- 24
- Pages
- 2369-2370
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2996079328
- Cited by
- 262
- References
- 1
- Citations by year
- 2026: 21 · 2025: 32 · 2024: 32 · 2023: 34 · 2022: 70 · 2021: 36 · 2020: 36
- FWCI
- 32.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
- Keywords
- place of death, home death, hospice deaths, nursing home deaths, in-hospital mortality, natural death, causes of death, cancer, dementia, cardiovascular disease, respiratory diseases, stroke, racial and ethnic disparities, sex differences, temporal trends
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Death, Female, Hospices, Hospitals, Humans, Male, Middle Aged, Nursing Homes, Residence Characteristics, United States
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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