Evidence map›Paper›PMID 26791258›Full record

SynthesisBMC palliative care2016

The determinants of home and nursing home death: a systematic review and meta-analysis.

Vania Costa, Craig C Earle, Mary Jane Esplen, Robert Fowler, Russell Goldman, Daphna Grossman, Leslie Levin, Douglas G Manuel, Shirlee Sharkey, Peter Tanuseputro and 1 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC palliative care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 4 pooled it
15.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 4 syntheses or guidelines pooled it, 194 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Review
  6. Article
  7. Review
  8. Article
  9. Trends in place of death in Peru, 2017-2024: a nationwide analysis.Archives of public health = Archives belges de sante publique · 2026
    Article
  10. Article
  11. Article
  12. Article
  13. Bridging policy and practice: Determinants of place of death for palliative care recipients in Taiwan.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 1 country.

Vania CostaHealth Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, M5S 1 N5, ON, Canada. costavania@hotmail.com.
Craig C EarleOntario Institute for Cancer Research, 101 College Street, Toronto, M5G 1 L7, ON, Canada.
Mary Jane Esplende Souza Institute, University Health Network, 700 Bay Street, 19th floor, Toronto, M5G 1Z6, ON, Canada.
Robert FowlerDepartment of Medicine and Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, M4N 3M5, ON, Canada.
Russell GoldmanMount Sinai Hospital, Tammy Latner Centre for Palliative Care, 60 Murray Street, 4th Floor, Box 13, L4-000, Toronto, M5T 3 L9, ON, Canada.
Daphna GrossmanNorth York General Hospital, 4001 Leslie Street, Toronto, M2K 1E1, ON, Canada.
Leslie LevinMaRS Discovery District, 101 College Street, Toronto, M5G 1 L7, ON, Canada.
Douglas G ManuelOttawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, K1Y 4E9, ON, Canada.
Shirlee SharkeySaint Elizabeth Health Care , 90 Allstate Parkway, Suite 300, Markham, L3R 6H3, ON, Canada.
Peter TanuseputroOttawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, K1Y 4E9, ON, Canada.
John J YouDepartments of Medicine, and Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, L8S 4 K1, ON, Canada.
Ottawa Hospital · CAHealth Sciences Centre · CAMaRS · CAMcMaster University · CAMount Sinai Hospital · CANorth York General Hospital · CAOntario Institute for Cancer Research · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMost Canadians die in hospital, and yet, many express a preference to die at home. Place of death is the result of the interaction among sociodemographic, illness- and healthcare-related factors. Although home death is sometimes considered a potential indicator of end-of-life/palliative care quality, some determinants of place of death are more modifiable than others. The objective of this systematic review was to evaluate the determinants of home and nursing home death in adult patients diagnosed with an advanced, life-limiting illness.

methodsA systematic literature search was performed for studies in English published from January 1, 2004 to September 24, 2013 that evaluated the determinants of home or nursing home death compared to hospital death in adult patients with an advanced, life-limiting condition. The adjusted odds ratios, relative risks, and 95% confidence intervals of each determinant were extracted from the studies. Meta-analyses were performed if appropriate. The quality of individual studies was assessed using the Newcastle-Ottawa scale and the body of evidence was assessed according to the GRADE Working Group criteria.

resultsOf the 5,900 citations identified, 26 retrospective cohort studies were eligible. The risk of bias in the studies identified was considered low. Factors associated with an increased likelihood of home versus hospital death included multidisciplinary home palliative care, preference for home death, cancer as opposed to other diagnoses, early referral to palliative care, not living alone, having a caregiver, and the caregiver's coping skills.

conclusionsKnowledge about the determinants of place of death can be used to inform care planning between healthcare providers, patients and family members regarding the feasibility of dying in the preferred location and may help explain the incongruence between preferred and actual place of death. Modifiable factors such as early referral to palliative care, presence of a multidisciplinary home palliative care team were identified, which may be amenable to interventions that improve the likelihood of a patient dying in the preferred location. Place of death may not be a very good indicator of the quality of end-of-life/palliative care since it is determined by multiple factors and is therefore dependent on individual circumstances.

Indexed as

DeathAttitude to DeathCanadaHealth PlanningHome Care ServicesHumansNursing HomesOutcome Assessment, Health CareRetrospective StudiesTerminal Care

Identifiers

PMID26791258
PMCPMC4721064
OpenAlexW2264947496

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.