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Deaths Registered as Occurring 'Elsewhere'
Deaths Registered as Occurring 'Elsewhere'
Deaths Registered as Occurring 'Elsewhere'
Deaths Registered as Occurring 'Elsewhere'
Deaths Registered as Occurring 'Elsewhere'
Deaths Registered as Occurring 'Elsewhere'
Deaths Registered as Occurring 'Elsewhere'
Deaths Registered as Occurring 'Elsewhere'
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Deaths Registered as Occurring 'Elsewhere'

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Deaths Registered as Occurring 'Elsewhere' …

Deaths Registered as Occurring 'Elsewhere'
15 February 2011 - National End of Life Care Intelligence Network (NEoLCIN) / National End of Life Care Programme

In the three year period between 2007 and 2009 by ONS 26,716 deaths (2% of all deaths) are described by ONS as occurring at "other private address or other place".

This phrase means an address not recognised as a communal establishment and not the persons usual place of residence.

This report analyses deaths registered as occurring elsewhere during that three year period.

Published in: Health & Medicine
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  • 1. National End of Life Care Programme Improving end of life care Deaths Registered as Occurring ‘Elsewhere’ T PUBLIC EA SOU LTH TH ES H W OBS ER www.endoflifecare-intelligence.org.uk V AT ORY
  • 2. Deaths Registered as Occurring ‘Elsewhere’ National End of Life Care Intelligence Network Authors Andy Pring, Senior Analyst, South West Public Health Observatory Dr Julia Verne, Director, South West Public Health Observatory Contents 1. Introduction ................................................................................................................................. 2 1.2 Definition of terms .............................................................................................................. 2 1.3 Note on the source of data in this report ............................................................................ 2 2. Number of deaths that occur „Elsewhere‟ .................................................................................. 2 3. Variation with age ....................................................................................................................... 3 3.1 3.2 4. The proportion of deaths that occur „Elsewhere‟ by age .................................................... 3 Distribution of deaths by age .............................................................................................. 3 Variation with gender .................................................................................................................. 4 4.1 5. Gender and age ................................................................................................................. 4 Variation with cause of death ..................................................................................................... 4 5.1 Cause of death and age ..................................................................................................... 5 5.2 Cause of death and gender ................................................................................................ 5 Publication details Published by: National End of Life Care Intelligence Network Publication date: February 2011 ISBN: 978-0-9569225-8-8 1
  • 3. Deaths Registered as Occurring ‘Elsewhere’ National End of Life Care Intelligence Network 1. Introduction The deaths of 1,405,722 people were registered in the three year period between 2007 and 2009 by ONS, an average of 468,574 each year. In these 3 years 26,716 deaths (2% of all deaths) are described by ONS as occurring at “other private address or other place”. This phrase means an address not recognised as a communal establishment and not the persons usual place of residence. Other places include other people‟s residence, roads (traffic accidents), public venues (sports venues, shops, restaurants…), work places, parks, woods, etc. People who are pronounced dead on arrival at hospital will also be in this group. The End of Life Care Intelligence Network reports and maps have routinely included all the nonmedical communal establishments together with all the places cited above into an elsewhere category. This captures a further 1,937 deaths, totalling 28,653. The 1,937 deaths occurred at convents, prisons, hostels, homes for the disabled etc. This report has concentrated on the ONS defined 26,716 deaths. It would have been useful to distinguish private from public addresses as place of death categories with „Elsewhere‟ i.e. identify deaths which occurred at another person‟s home, however the available place of death description does not make that easily possible. For ease of reporting, all deaths are given a postcode, but it is not possible to be certain, for example, whether a death occurred inside or outside of a building, or whether an address is a private residence or public building or private business address. 1.2 Definition of terms The definition of the term used throughout this report is given as; Underlying cause of death: is the disease or injury that initiated the train of events directly linked to death; or the circumstances of the accident or violence that produced the fatal injury. 1.3 Note on the source of data in this report Information in this report has been derived from the Annual Public Health Mortality Extract (2010), produced by the Office of National Statistics based on Death Certificate data. 2. Number of deaths that occur ‘Elsewhere’ Of the 1,405,722 deaths registered between 2007 and 2009, 26,716 (2%) died elsewhere. 2
  • 4. Deaths Registered as Occurring ‘Elsewhere’ National End of Life Care Intelligence Network 3. Variation with age 3.1 The proportion of deaths that occur ‘Elsewhere’ by age Although 2% of all deaths occurred „Elsewhere‟, this proportion varies considerably by age. 16% of deaths of people aged 1-19 years and 19% of deaths of people aged 20-39 years occurred „Elsewhere‟ (Table 1). The proportion of deaths in the most elderly people (80 years or over) that occurred „Elsewhere‟ was the lowest (1%) of all age-bands other than 0 years. Table 1: Proportion of all deaths that occur ‘Elsewhere’ by age Age in years (%) 0 Elsewhere 1-19 1 20-39 40-59 60-79 16 19 5 80+ 2 1 All ages 2 Source: ONS Annual Public Health Mortality Extract (2010) 3.2 Distribution of deaths by age Most deaths between 2007 and 2009 were aged 80 years or older (53%). Those deaths that occur „Elsewhere‟ are much less dominated by the elderly, about half of all „Elsewhere‟ deaths were under 60 years of age (49%) compared with 12% of all deaths (Table2). Table 2: Proportion of deaths that occur in each age-band: ‘Elsewhere’ and all deaths Age in years (%) 0 1-19 20-39 40-59 60-79 80+ Total Elsewhere 0 4 20 25 30 21 100 All deaths 1 0 2 9 35 53 100 Source: ONS Annual Public Health Mortality Extract (2010) 3
  • 5. Deaths Registered as Occurring ‘Elsewhere’ National End of Life Care Intelligence Network 4. Variation with gender Most „Elsewhere‟ deaths occur in males (68%) compared with 48% of all deaths. 4.1 Gender and age The variation with age is stronger within males than females – about a 1 in 5 of deaths in males aged under 40 years occur „Elsewhere‟, compared to about 1 in 10 of deaths in females aged under 40 (Figure 1). Figure 1: Proportion of all deaths that occur Elsewhere by sex Percentage of deaths 25% 20% 15% 10% 5% 0% 0 1-19 20-39 40-59 60-79 80+ All ages Age in years Male Female Source: ONS Annual Public Health Mortality Extract (2010) 5. Variation with cause of death Many of the „Elsewhere‟ deaths have External Cause as the underlying cause of death (Table 3). „Elsewhere‟ deaths will include many fatal transport accidents together with deaths caused by other accidents, assaults and self harm many of which will occur outside the home, possibly in a public place. Table 3: Distribution of underlying cause of death Cause of death Acute cardio-vascular (inc stroke and myocardial infarction) Cancer Other non-external causes Self harm or Open Transport Accident External Falls & Other causes accidents Assault All causes Elsewhere (%) All deaths (%) 28 30 18 16 15 14 28 38 1 1 7 2 2 100 <0.5 100 Source: ONS Annual Public Health Mortality Extract (2010) 4
  • 6. Deaths Registered as Occurring ‘Elsewhere’ National End of Life Care Intelligence Network 5.1 Cause of death and age Death „Elsewhere‟ caused by Transport accidents, Self harm or open verdict, assault and other accidents are concentrated in younger people (20-60 years), see Table 4. While older people are susceptible to falls that can occur „Elsewhere‟, they are likely to survive long enough to be moved home or to hospital so the place of death is not “Elsewhere”. Table 4: Proportion (%) of ‘Elsewhere’ deaths within each cause by age-band Age in years (%) 0 Acute cardio-vascular (inc stroke and myocardial infarction) Cancer Other non-external causes Self harm or open External verdict causes Transport accident Falls & other accidents Assault All causes 1-19 20-39 40-59 60-79 80+ All ages 0 0 1 0 0 2 2 3 18 22 14 24 48 46 25 28 37 30 100 100 100 0 0 4 15 41 43 41 27 12 11 2 4 100 100 0 0 0 7 16 4 45 48 20 34 25 25 9 9 30 5 2 21 100 100 100 Source: ONS Annual Public Health Mortality Extract (2010) 5.2 Cause of death and gender The distribution of cause of deaths the occur „Elsewhere‟ differ between the genders (chart); External causes are more common amongst males. While among „Elsewhere‟ deaths acute cardio-vascular disease is more common in males than females, both cancer and other non-external causes are more common in females. As women tend to outlive their spouse, it could be that women are more likely than men to die in the home of a relative i.e. in a place other than their usual residence. Figure 2: The distribution of ‘Elsewhere’ deaths by cause of death for each gender Percentage of deaths 40 20 0 20 40 Cardio-vascular Cancer External causes Other non-external causes Self harm or Open Transport Accident Falls and Other accidents Assault Male Female Source: Office of National Statistics Annual Public Health Mortality Extract (2010) 5
  • 7. About the South West Public Health Observatory About the National End of Life Care Intelligence Network The South West Public Health Observatory (SWPHO) is part of a network of regional public health observatories in the UK and Ireland. These were established in 2000 as outlined in the Government White Paper Saving lives: our healthier nation. Key tasks include: monitoring health and disease trends; identifying gaps in health information; advising on methods for health and health impact assessment; drawing together information from different sources; and carrying out projects on particular health issues. The Department of Health’s National End of Life Care Strategy, published in 2008, pledged to commission a National End of Life Care Intelligence Network (NEoLCIN). The Network was launched in May 2010. It is tasked with collating existing data and information on end of life care for adults in England. This is with the aim of helping the NHS and its partners commission and deliver high quality end of life care, in a way that makes the most efficient use of resources and responds to the wishes of dying people and their families. The SWPHO incorporates the National Drug Treatment Monitoring System South West (NDTMSSW), and in April 2005 merged with the South West Cancer Intelligence Service (SWCIS). The SWPHO works in partnership with a wide range of agencies, networks and organisations regionally and nationally to provide ‘a seamless public health intelligence service’ for the South West. For more information about the SWPHO and its partners, please visit www.swpho.nhs.uk. Photograph on front cover supplied by Duchessa. SWPHO is part of the UK & Ireland Association of Public Health Observatories. Key partners include the National Cancer Intelligence Network (NCIN), which will work closely with the Network to improve end of life care intelligence; and the South West Public Health Observatory, lead public health observatory for end of life care, which hosts the NEoLCIN website. The SWPHO has been commissioned to produce key outputs and analyses for the Network, including the national End of Life Care Profiles. See www.endoflifecare-intelligence.org.uk for more information about the Network and its partners. © Crown Copyright 2011

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