An Examination of Factors Related to Location of Death: Does Socio-Economic Status Matter? MANITOBA CENTRE FOR HEALTH POLICY Verena Menec Lisa Lix Carmen Steinbach Oke Ekuma Monica Sirski Ruth-Ann Soodeen

Most people die in hospital even though most would prefer to die at home. Inconsistent results in terms of whether socio-economic status is related to location of death. The Issue

To examine whether socio-economic status is related to location of death. Objective

All adults (19+ years old) who died in Manitoba in 2000/01 9436 individuals The Population

Administrative Data Hospital Nursing Home Home Care Population - Based Research Registry Vital Statistics Home Care Nursing Home Hospital Census

Age Cause of death Gender Marital status Income quintiles Predictors

Outcome Variables Long-term care, home care, Other Location vs. hospital Hospital, home care, Other Location vs. palliative unit Among hospital deaths - “regular ward”, ICU vs. palliative unit

Regression Results: Age 65+ * p < .01; ** p < .001

Regression Results: Cancer * p < .05

Key Findings Cause of death and age are major predictors of location of death. Few income effects, although for cancer deaths, the wealthiest were more likely to die on home care, relative to in a palliative care unit, than the poorest.

Conclusions Despite the availability of palliative home care, there may be barriers to dying at home for the poorest. Whether the new Palliative Drug Access program will reduce barriers for the less wealthy needs to be examined.

M Manitoba Centre for Health Policy C H P