Aim: The aim of the research was to determine the fulfilment of the standard operating procedure - "Care of patients with increased risk levelˮ incorporating the JCI AOP 1.7 standard "Patients and their loved ones are investigated and reinvestigated due to their individualized needsˮ by healthcare professionals of the selected healthcare facility. Design: A cross-sectional study. Methods: A quantitative survey was selected for data collection. The data were obtained through structured interviews with selected healthcare professionals from the designated facilities conducted by hospital management and recorded in writing in a pre-prepared record sheet. The research sample consisted of 78 respondents, of whom 36 were physicians and 42 were nurses, from 14 facilities. The research was conducted from 15. 1. - 31. 12. 2018. Results: From the interviews, we found that respondents regarded terminal patients and their loved ones holistically, but failed to record the information obtained. We also found that there was no difference in the evaluation of the patient and his / her loved ones according to the profession of the respondents, the length of their medical practice, or their workplace. In terms of the respondentsʼ workplace, there was no difference in perceptions of the quality of palliative care provided in the selected hospital. Conclusion: Respondents perceive patients holistically and they are assessed as a bio-psycho-socio-spiritual unit, and their loved ones are included in the assessment. However, the information obtained is not fully documented in written form.

• MeSH
• dodržování směrnic MeSH
• kvalita zdravotní péče statistika a číselné údaje   MeSH
• lidé MeSH
• paliativní péče * metody   normy   psychologie   statistika a číselné údaje   MeSH
• péče o umírající metody   normy   psychologie   statistika a číselné údaje   MeSH
• rozhovory jako téma MeSH
• zdravotnický personál psychologie   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• eutanazie * etika   statistika a číselné údaje   MeSH
• jednotky intenzivní péče etika   MeSH
• kritický stav MeSH
• kvalita života MeSH
• lidé MeSH
• nenasazení léčby etika   statistika a číselné údaje   MeSH
• péče o pacienty v kritickém stavu * etika   MeSH
• péče o umírající etika   statistika a číselné údaje   MeSH
• podpůrné srdeční systémy etika   MeSH
• rozhodování etika   MeSH
• vztahy mezi odborníkem a rodinou etika   MeSH
• Check Tag
• lidé MeSH

BACKGROUND: To implement the appropriate services and develop adequate interventions, detailed estimates of the needs for palliative care in the population are needed. AIM: To estimate the proportion of decedents potentially in need of palliative care across 12 European and non-European countries. DESIGN: This is a cross-sectional study using death certificate data. SETTING/PARTICIPANTS: All adults (⩾18 years) who died in 2008 in Belgium, Czech Republic, France, Hungary, Italy, Spain (Andalusia, 2010), Sweden, Canada, the United States (2007), Korea, Mexico, and New Zealand ( N = 4,908,114). Underlying causes of death were used to apply three estimation methods developed by Rosenwax et al., the French National Observatory on End-of-Life Care, and Murtagh et al., respectively. RESULTS: The proportion of individuals who died from diseases that indicate palliative care needs at the end of life ranged from 38% to 74%. We found important cross-country variation: the population potentially in need of palliative care was lower in Mexico (24%-58%) than in the United States (41%-76%) and varied from 31%-83% in Hungary to 42%-79% in Spain. Irrespective of the estimation methods, female sex and higher age were independently associated with the likelihood of being in need of palliative care near the end of life. Home and nursing home were the two places of deaths with the highest prevalence of palliative care needs. CONCLUSION: These estimations of the size of the population potentially in need of palliative care provide robust indications of the challenge countries are facing if they want to seriously address palliative care needs at the population level.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• odhad potřeb MeSH
• paliativní péče statistika a číselné údaje   MeSH
• péče o umírající statistika a číselné údaje   MeSH
• průřezové studie MeSH
• ROC křivka MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• zdravotnické služby - potřeby a požadavky statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dětské nemocnice MeSH
• paliativní péče organizace a řízení   statistika a číselné údaje   MeSH
• péče o umírající * organizace a řízení   statistika a číselné údaje   MeSH
• Publikační typ
• rozhovory MeSH

Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death. Of 5,568,827 deaths, 5.8% were from lung cancer and 4.4% from chronic obstructive pulmonary disease. Among lung cancer decedents, home deaths ranged from 12.5% in South Korea to 57.1% in Mexico, while hospital deaths ranged from 27.5% in New Zealand to 77.4% in France. In chronic obstructive pulmonary disease patients, the proportion dying at home ranged from 10.4% in Canada to 55.4% in Mexico, while hospital deaths ranged from 41.8% in Mexico to 78.9% in South Korea. Controlling for age, sex, and marital status, patients with chronic obstructive pulmonary disease were significantly less likely die at home rather than in hospital in nine countries. Our study found in almost all countries that those dying from chronic obstructive pulmonary disease as compared with those from lung cancer are less likely to die at home and at a palliative care institution and more likely to die in a hospital or a nursing home. This might be due to less predictable disease trajectories and prognosis of death in chronic obstructive pulmonary disease. LUNG DISEASE: IMPROVING END-OF-LIFE CARE: Structured palliative care similar to that offered to cancer sufferers should be in place for patients with chronic lung disease. Joachim Cohen at Vrije University in Brussels and co-workers examined international death certificate data collected from 14 countries to determine place of death for patients with lung cancer and chronic obstructive pulmonary disease (COPD). While patients with COPD suffer similar symptoms to lung cancer in their final days, few COPD patients receive palliative care or achieve the common wish of dying at home. This may be partly due to the inherent unpredictability of final-stage COPD compared with lung cancer. Cohen's team found that, with the exception of Italy, Spain, and Mexico, patients with COPD were significantly more likely to die in hospital than at home. They highlight the need for improved COPD palliative care provision.

• MeSH
• chronická obstrukční plicní nemoc * MeSH
• dospělí MeSH
• hospice * MeSH
• hospitalizace statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• logistické modely MeSH
• manželský stav MeSH
• mladiství MeSH
• mladý dospělý MeSH
• multivariační analýza MeSH
• nádory plic * MeSH
• nemocnice * MeSH
• paliativní péče MeSH
• péče o umírající statistika a číselné údaje   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• služby domácí péče statistika a číselné údaje   MeSH
• smrt * MeSH
• úmrtní listy MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH
• Korejská republika MeSH
• Nový Zéland MeSH
• Severní Amerika MeSH

Cross-national understanding of place of death is crucial for health service systems for their provision of efficient and equal access to paediatric palliative care. The objectives of this population-level study were to examine where children with complex chronic conditions (CCC) die and to investigate associations between places of death and sex, cause of death and country. The study used death certificate data of all deceased 1- to 17-year-old children (n = 40,624) who died in 2008, in 11 European and non-European countries. Multivariable logistic regression was performed to determine associations between place of death and other factors. Between 24.4 and 75.3% of all children 1-17 years in the countries died of CCC. Of these, between 6.7 and 42.4% died at home. In Belgium and the USA, all deaths caused by CCC other than malignancies were less likely to occur at home, whereas in Mexico and South Korea, deaths caused by neuromuscular diseases were more likely to occur at home than malignancies. In Mexico (OR = 0.91, 95% CI: 0.83-1.00) and Sweden (OR = 0.35, 95% CI: 0.15-0.83), girls had a significantly lower chance of dying at home than boys. CONCLUSION: This study shows large cross-national variations in place of death. These variations may relate to health system-related infrastructures and policies, and differences in cultural values related to place of death, although this needs further investigation. The patterns found in this study can inform the development of paediatric palliative care programs internationally. What is known: • There is a scarcity of population-level studies investigating where children with CCC die in different countries. • Cross-national understanding of place of death provides information to health care systems for providing efficient and equal access to paediatric palliative care. What is new : • There are large cross-national variations in the place of death of children with CCC, with few deathsoccuring at home in some countries whereas hospital deaths are generally most common. • In general, deaths caused by neuromuscular diseases and malignancies occur at home more often thanother CCC.

• MeSH
• charakteristiky bydlení * MeSH
• chronická nemoc mortalita   MeSH
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• logistické modely MeSH
• mladiství MeSH
• mortalita v nemocnicích MeSH
• odds ratio MeSH
• péče o umírající statistika a číselné údaje   MeSH
• předškolní dítě MeSH
• příčina smrti MeSH
• rozložení podle pohlaví MeSH
• smrt * MeSH
• srovnání kultur MeSH
• umírající statistika a číselné údaje   MeSH
• úmrtní listy MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH
• Kanada MeSH
• Korejská republika MeSH
• Mexiko MeSH
• Nový Zéland MeSH
• Spojené státy americké MeSH

Rychle probíhající demografické změny a měnící se spektrum nemocí ovlivňují i požadavky na systémy zdravotní a sociální péče. Klesající úmrtnost v jednotlivých věkových kategoriích a rostoucí střední délka života se odrážejí ve struktuře uživatelů zdravotních služeb, struktuře příčin úmrtí a samozřejmě také ve věkové struktuře zemřelých osob. Česká republika patří mezi země s rychle stárnoucí populací. Přestože si většina lidí přeje nejen žít, ale také zemřít doma, v roce 2012 téměř tři čtvrtiny lidí zemřely v nemocnici nebo v jiném zdravotnickém a sociálním zařízení. Přes zhoršující se zdravotní stav obyvatel pobytových zařízení sociálních služeb a vysoký počet lidí, kteří v nich umírají, je zajištění zdravotní péče v těchto zařízeních u nás zatím problematické. Paliativní a dlouhodobá péče by měly být poskytovány tak, aby byly schopny reagovat na měnící se potřeby naší populace, a to bez ohledu na resort, ve kterém se tato zařízení nacházejí.

Rapid demographic changes and rising prevalence of chronic disease bring about changing demands on health and social care. Declining mortality in higher age groups and increasing life expectancy results in changing structure of users of health services, the structure of causes of death and, of course, in the age distribution of deaths. The Czech Republic is among the countries with the most rapidly aging populations. Although large majority of people wish to age and also to die at home, in 2012, nearly three-quarters of people died in a hospital or other health and social facilities. Despite the deteriorating health of residents of residential social services and the high and increasing number of people dying in those institutions, the availability and quality of health care in those facilities is very problematic. Palliative care and long-term care should respond to the changing needs of our population, arising from rapidly ageing population and increasing prevalence of chronic diseases, regardless of whether such care is provided in health or social care facilities.

• Klíčová slova
• místo úmrtí, domácí prostředí,
• MeSH
• demografie MeSH
• dlouhodobá péče organizace a řízení   statistika a číselné údaje   MeSH
• domovy pro seniory MeSH
• lidé MeSH
• mortalita v nemocnicích MeSH
• mortalita MeSH
• nemocnice pro chronická onemocnění MeSH
• paliativní péče * organizace a řízení   statistika a číselné údaje   MeSH
• péče o umírající * organizace a řízení   statistika a číselné údaje   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ubytovací zařízení MeSH
• umírající statistika a číselné údaje   MeSH
• zdravotní péče - plánování MeSH
• zdravotní politika MeSH
• zdravotnická zařízení MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

OBJECTIVES: The objective of this study was to examine variation in place of death of older people dying from dementia in countries across 4 continents. DESIGN: Study of death certificate data. METHODS: We included deaths of older (65 + years) people whose underlying cause of death was a dementia-related disease (ICD-10: F01, F02, F03, G30) in Belgium, the Netherlands, England, Wales, France, Italy, Spain, Czech Republic, Hungary, New Zealand, United States, Canada, Mexico and South Korea. We examined associations between place of death and sociodemographic factors, social support, and residential and health care system factors. RESULTS: Overall, 4.8% of all deaths were from a dementia-related disease, ranging from 0.4% in Mexico to 6.9% in Canada. Of those deaths, the proportion occurring in hospital varied from 1.6% in the Netherlands to 73.6% in South Korea. When controlling for potential confounders, hospital death was more likely for men, those younger than 80, and those married or living in a region with a higher availability of long-term care beds, although this could not be concluded for each country. Hospital death was least likely in the Netherlands compared with other countries. CONCLUSIONS: Place of death of older people who died from a dementia-related disease differs substantially between countries, which might point to organizational differences in end-of-life care provision. Increasing the availability of long-term care beds might be important to reduce the number of hospital deaths, while focusing specialized end-of-life care services on married people or those aged 65 to 79 might be crucial for achieving home death. However, proper end-of-life care needs to be ensured in hospitals, should this be the most appropriate end-of-life care setting.

• MeSH
• databáze faktografické MeSH
• demence diagnóza   mortalita   MeSH
• dlouhodobá péče statistika a číselné údaje   MeSH
• internacionalita MeSH
• interval spolehlivosti MeSH
• lidé MeSH
• logistické modely MeSH
• mortalita v nemocnicích trendy   MeSH
• multivariační analýza MeSH
• odds ratio MeSH
• péče o umírající statistika a číselné údaje   MeSH
• pečovatelské domovy statistika a číselné údaje   zásobování a distribuce   MeSH
• příčina smrti MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• úmrtní listy * MeSH
• zeměpis MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa MeSH
• Korea MeSH
• Nový Zéland MeSH

BACKGROUND: Where people die can influence a number of indicators of the quality of dying. We aimed to describe the place of death of people with cancer and its associations with clinical, socio-demographic and healthcare supply characteristics in 14 countries. METHODS: Cross-sectional study using death certificate data for all deaths from cancer (ICD-10 codes C00-C97) in 2008 in Belgium, Canada, Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (2010), USA (2007) and Wales (N=1,355,910). Multivariable logistic regression analyses evaluated factors associated with home death within countries and differences across countries. RESULTS: Between 12% (South Korea) and 57% (Mexico) of cancer deaths occurred at home; between 26% (Netherlands, New Zealand) and 87% (South Korea) occurred in hospital. The large between-country differences in home or hospital deaths were partly explained by differences in availability of hospital- and long-term care beds and general practitioners. Haematologic rather than solid cancer (odds ratios (ORs) 1.29-3.17) and being married rather than divorced (ORs 1.17-2.54) were most consistently associated with home death across countries. CONCLUSIONS: A large country variation in the place of death can partly be explained by countries' healthcare resources. Country-specific choices regarding the organisation of end-of-life cancer care likely explain an additional part. These findings indicate the further challenge to evaluate how different specific policies can influence place of death patterns.

• MeSH
• dítě MeSH
• dlouhodobá péče statistika a číselné údaje   MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory mortalita   MeSH
• nemocnice statistika a číselné údaje   MeSH
• novorozenec MeSH
• paliativní péče statistika a číselné údaje   MeSH
• péče o umírající statistika a číselné údaje   MeSH
• předškolní dítě MeSH
• příčina smrti MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úmrtní listy MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

BACKGROUND: Most people prefer to receive end-of-life care in familiar surroundings rather than in hospital. This study examines variation in place of death for people dying from Parkinson's disease (PD) across 11 European and non-European countries. METHODS: Using death certificate data of 2008 for Belgium, France, Italy, Hungary, Czech Republic, New Zealand, USA, Canada, Mexico, South Korea and Spain for all deaths with PD as an underlying cause (ICD-10 code: G20) cross-national differences in place of death were examined. Associations between place of death and patient socio-demographic and regional characteristics were evaluated using multivariable binary logistic regression analyses. RESULTS: The proportion of deaths in hospital ranged from 17% in the USA to 75% in South Korea. Hospital was the most prevalent place of death in France (40%), Hungary (60%) and South Korea; nursing home in New Zealand (71%), Belgium (52%), USA (50%), Canada (48%) and Czech Republic (44%); home in Mexico (73%), Italy (51%) and Spain (46%). The chances of dying in hospital were consistently higher for men (Belgium, France, Italy, USA, Canada), those younger than 80 years (Belgium, France, Italy, USA, Mexico), and those living in areas with a higher provision of hospital beds (Italy, USA). CONCLUSIONS: In several countries a substantial proportion of deaths from PD occurs in hospitals, although this may not be the most optimal place of terminal care and death. The wide variation between countries in the proportion of deaths from PD occurring in hospital indicates a potential for many countries to reduce these proportions.

• MeSH
• charakteristiky bydlení MeSH
• lidé středního věku MeSH
• lidé MeSH
• lůžková kapacita nemocnice MeSH
• nemocnice statistika a číselné údaje   MeSH
• Parkinsonova nemoc mortalita   MeSH
• péče o umírající statistika a číselné údaje   MeSH
• pečovatelské domovy statistika a číselné údaje   MeSH
• příčina smrti MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sexuální faktory MeSH
• smrt * MeSH
• socioekonomické faktory MeSH
• srovnání kultur MeSH
• úmrtní listy MeSH
• věkové faktory MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH