Whether developments in palliative care have impacted on where cancer patients die is unknown. We investigated time trends in place of death for colorectal cancer.
Details were abstracted on 10,175 colorectal cancer deaths during 1994-2004. Time trends were analysed by joinpoint regression.
half (49%) of deaths occurred in acute hospitals, 29% at home, 13% in
hospices and 7% in nursing homes. Hospital deaths were unchanged over
time. Hospice deaths rose from 6% in 1994 to 17% in 2003. Home deaths
decreased significantly, but only in health boards with hospices
[estimated annual percentage change (EAPC) = -3.6%, 95%CI -4.19 to
-2.97%, p < 0.001]. Nursing home deaths rose significantly in areas
without hospices (EAPC = 8.0%, 95%CI 2.27 to -13.94%, p = 0.011).
Most colorectal cancer deaths occur in hospital. Availability of hospice facilities is a key determinant of where the burden of death falls. The results suggest unmet demand for hospice care in Ireland.