1. Deaths in New Zealand: Place of Death 2000 to 2010 May 2014

2. Ministry of Health MORT Data Data collected continuously; cause of death added. Based on year of registration of death, with around 3% of deaths recorded after year of death. Publications produced annually with a delay: 2010 released October 2013 Detailed data requested, with one record for each death. De-identified data received for 311,212 deaths including underlying cause of death, contributory causes and place of death.

3. Deaths in New Zealand 2000-2010 There has been remarkable stability in the total number of deaths over this period, with perhaps only a very small increase. Source: Analysis of Ministry of Health MORT data 2000 to 2010

4. Deaths in New Zealand 2000-2010 Over the period, 96.7% of deaths were in the same year as registration; 3.2% of deaths were in the prior year with only 0.1% in earlier years. Sometimes very old deaths finally registered, for example two deaths in 1938 were registered in 2010. Work with year of registration for all analysis. Source: Analysis of Ministry of Health MORT data 2000 to 2010

5. Age and Gender

6. Deaths in New Zealand 2000-2010 This analysis uses age bands to age 95+ to give more information on patterns at the oldest ages. 30.1% of all deaths are over age 85. Source: Analysis of Ministry of Health MORT data 2000 to 2010

7. Deaths in New Zealand 2000-2010 Very little change in proportion of female and male deaths over this period. Equal proportions with some annual variation. Source: Analysis of Ministry of Health MORT data 2000 to 2010

8. Place of Death 2000-2010 61.0% of deaths in residential care are women, while only 41.3% of deaths in private residence are women. Source: Analysis of Ministry of Health MORT data 2000 to 2010

9. Deaths in New Zealand 2000-2010 30.1% of all deaths are over age 85; 60.1% are over age 75 and 77.4% are over age 65. Source: Analysis of Ministry of Health MORT data 2000 to 2010

10. Deaths in New Zealand 2000-2010 Male 30.1% of all deaths are over age 85; 60.1% are over age 75 and 77.4% are over age 65. Source: Analysis of Ministry of Health MORT data 2000 to 2010

11. Deaths in New Zealand 2000-2010 Female 30.1% of all deaths are over age 85; 60.1% are over age 75 and 77.4% are over age 65. Source: Analysis of Ministry of Health MORT data 2000 to 2010

12. Deaths in New Zealand 2000-2010 30.1% of all deaths are over age 85. But 39.3% of female deaths are over age 85, while only 21.0% of male deaths are in that age band, Source: Analysis of Ministry of Health MORT data 2000 to 2010

13. Deaths in New Zealand 2000-2010 Note steady increase in deaths over age 85 over the period, from 25.9% of deaths in 2000 to 33.2% of deaths in 2010. Decline in deaths age 65-74. Source: Analysis of Ministry of Health MORT data 2000 to 2010

14. Different age profiles for male and female deaths. By 2010, male deaths over age 75 were 54.9% of all deaths. Deaths over age 85 were 24.3% of the total. Source: Analysis of Ministry of Health MORT data 2000 to 2010 Male Deaths in New Zealand 2000-2010

15. Source: Analysis of Ministry of Health MORT data 2000 to 2010 Female Deaths in New Zealand 2000-2010 Note much older profile of female deaths. By 2010, female deaths over age 75 were 68.3% of all deaths. Deaths over age 85 were 42.2% of the total.

16. Deaths in New Zealand 2000-2010 With combined male and female deaths, seems as if deaths age 75-84 and deaths age 85+ are roughly of the same magnitude. However very different patterns for male and female. Source: Analysis of Ministry of Health MORT data 2000 to 2010

17. For men, deaths age 75-84 are the largest category and reasonably stable. Deaths over age 85 beginning to rise. Source: Analysis of Ministry of Health MORT data 2000 to 2010 Male Deaths in New Zealand 2000-2010

18. For women, deaths over age 85 have been the largest category over the whole period and continue to rise. Deaths age 75-84 declining. Source: Analysis of Ministry of Health MORT data 2000 to 2010 Female Deaths in New Zealand 2000-2010

19. Place of Death 2000-2010 Major difference in age of death between residential care and hospice inpatient unit. Source: Analysis of Ministry of Health MORT data 2000 to 2010

20. Place of Death 2000-2010 Major difference in age of death between residential care and hospice inpatient unit. Differences by gender for all settings. Source: Analysis of Ministry of Health MORT data 2000 to 2010

21. Ethnicity

22. Ethnicity of Deaths 2000-2010 15.4% of deaths are Māori, Pacific or Asian. 84.6% of deaths are in the Other category, which includes NZ European. Source: Analysis of Ministry of Health MORT data 2000 to 2010

23. Ethnicity of Deaths 2000-2010 60% of deaths under age 1 are Māori, Pacific or Asian. Very low numbers of deaths of these ethnic groups in the oldest years. Source: Analysis of Ministry of Health MORT data 2000 to 2010

24. Ethnicity of Deaths 2000-2010 Very gradual increase in proportion of deaths that are Māori, Pacific or Asia. 14.6% of total deaths in 2000, rising to 16.4% in 2010. Source: Analysis of Ministry of Health MORT data 2000 to 2010

25. Ethnicity of Deaths 2000-2010 Asian deaths increasing most rapidly, followed by Pacific Peoples and then Māori. Very large numbers of Other deaths (including NZ European) and thus the numbers grow more slowly. Source: Analysis of Ministry of Health MORT data 2000 to 2010

26. Place of Death 2000-2010 Very few Māori, Pacific and Asian deaths in residential care, with more deaths in private residence and other settings. Source: Analysis of Ministry of Health MORT data 2000 to 2010

27. Place of Death

28. Place of Death 2000-2010 34.2% in hospital, 30.7% in residential care and 22.3% in private residence. Note that this seriously undercounts hospice involvement as only hospice inpatient unit available as a place of death. Source: Analysis of Ministry of Health MORT data 2000 to 2010

29. Place of Death 2000-2010 Male 35.1% in hospital, 24.0% in residential care and 26.1% in private residence. Note that this seriously undercounts hospice involvement as only hospice inpatient unit available as a place of death. Source: Analysis of Ministry of Health MORT data 2000 to 2010

30. Place of Death 2000-2010 Female 33.3% in hospital, 37.5% in residential care and 18.4% in private residence. Note that this seriously undercounts hospice involvement as only hospice inpatient unit available as a place of death. Source: Analysis of Ministry of Health MORT data 2000 to 2010

31. Place of Death 2000-2010 Residential care accounts for 37.5% of female deaths but only 24.0 % of male deaths. Private residence accounts for only 18.4% of female deaths but 26.1% of male deaths. Source: Analysis of Ministry of Health MORT data 2000 to 2010

32. Place of Death 2000-2010 Overall, deaths in residential care accounted for 30.7%. Over time, an increasing proportion of deaths are in residential care, from 27.6% of deaths in 2000 to 32.3% of deaths in 2010. Source: Analysis of Ministry of Health MORT data 2000 to 2010

33. Overall, male deaths in residential care accounted for 24.0%. An increasing proportion of male deaths are in residential care, from 21.2% of deaths in 2000 to 25.8% of deaths in 2010. Source: Analysis of Ministry of Health MORT data 2000 to 2010 Place of Death 2000-2010 Male

34. Overall, female deaths in residential care accounted for 37.6%. An increasing proportion of female deaths are in residential care, from 34.5% of deaths in 2000 to 38.9% of deaths in 2010. Source: Analysis of Ministry of Health MORT data 2000 to 2010 Place of Death 2000-2010 Female

35. Place of Death 2000-2010 Over the period, deaths in public hospital and residential care have narrowed with the growth in deaths in residential care. Some increase in deaths in hospice inpatient unit. Source: Analysis of Ministry of Health MORT data 2000 to 2010

36. Place of Death 2000-2010 Male Hospital and private residence are most common places for male deaths. Deaths in residential care have increased over the period. Source: Analysis of Ministry of Health MORT data 2000 to 2010

37. Place of Death 2000-2010 Female Residential care is most common place for female deaths, with private residence much smaller than residential care or hospital. Source: Analysis of Ministry of Health MORT data 2000 to 2010

38. Place of Death 2000-2010 Very strong pattern with age: deaths in youngest age group have highest proportion elsewhere. 54.8% of deaths in oldest age group are in residential care. Highest proportion of deaths in hospice inpatient unit from age 40 to 75. Source: Analysis of Ministry of Health MORT data 2000 to 2010

39. Place of Death 2000-2010 In every age band, deaths of women are more likely to be in residential care. Source: Analysis of Ministry of Health MORT data 2000 to 2010

40. Place of Death 2000-2010 Note expanding funnel shape for residential care with age. Greater proportion of deaths of elderly women are in residential care, compared to elderly men. Source: Analysis of Ministry of Health MORT data 2000 to 2010

41. Place of Death 2000-2010 Age 85+ For deaths over age 85, 54.8% in residential care and only 9.9% in private residence. Some deaths in public hospital likely to be after transfer from residential care. Source: Analysis of Ministry of Health MORT data 2000 to 2010

42. Place of Death 2000-2010 18.6% of deaths from Neoplasms in hospice inpatient unit. 68.4% of deaths from mental, behavioural and nervous system conditions are in residential care. Source: Analysis of Ministry of Health MORT data 2000 to 2010

43. Place of Death 2000-2010 Female For all conditions, deaths of women more likely to be in residential care. 74.0% of deaths from mental, behavioural and nervous system conditions for women are in residential care. Source: Analysis of Ministry of Health MORT data 2000 to 2010

44. Place of Death 2000-2010 Male Higher proportion of male deaths from external causes are in other settings. 60.2% of deaths from mental, behavioural and nervous system conditions for men are in residential care. Source: Analysis of Ministry of Health MORT data 2000 to 2010

45. Place of Death and Specialist Palliative Care Services

46. Place of Death Hospice Patients 2012 24.4% of hospice patients died in a hospice in-patient unit. 33.9% died in a private residence and 24.9% in residential aged care. Hospice definitions used. Data source: Correspondence with Hospice NZ, March 2014.

47. Place of Death 2010 before Hospice Adjustment The patterns (not actual data) from the hospice benchmarking data in 2012 have been applied by indexing the deaths of clients in other settings to deaths in hospice inpatient units. The patterns were then applied to this MORT data. Source: Analysis of Ministry of Health MORT data 2000 to 2010

48. Place of Death 2010 after Hospice Adjustment The patterns (not actual data) from the hospice benchmarking data in 2012 have been applied by indexing the deaths of clients in other settings to deaths in hospice inpatient units. The patterns were then applied to this MORT data. Source: Analysis of Ministry of Health MORT data 2000 to 2010; with data from Hospice NZ

49. Hospital Specialist Palliative Care Discharge Outcomes Discharges to other settings to continue palliative care were made for 68.5% of patients, with 21.0% to a residential care facility and 41.8% to a private home. Source: Data supplied by Dr K. Grundy, Hospital Specialist Palliative Care Service, Christchurch Hospital, Canterbury DHB

50. Prof Heather McLeod Senior Analyst, Palliative Care Cancer Control New Zealand Office of the CMO Ministry of Health www.cancercontrolnz.govt.nz/palliative-care Email: Heather_McLeod@MOH.govt.nz Mobile: 0210 279 7425