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Factors associated with place of death for elderly Japanese-American men: the Honolulu Heart Program and Honolulu-Asia Aging Study

TitleFactors associated with place of death for elderly Japanese-American men: the Honolulu Heart Program and Honolulu-Asia Aging Study
Publication TypeJournal Article
Year of Publication2009
AuthorsBell, CL, Davis, J, Harrigan, RC, Somogyi-Zalud, E, Tanabe, MK, Masaki, KH
JournalJ Am Geriatr SocJ Am Geriatr Soc
Volume57
Pagination714-8
Date PublishedApr
ISBN Number1532-5415 (Electronic)<br/>0002-8614 (Linking)
Accession Number19175434
KeywordsAged, Aged, 80 and Over, Asian Americans, Cause of Death, Chi-Square Distribution, Death Certificates, Hawaii/epidemiology, Home Care Services/ utilization, Hospitals/ utilization, Humans, Japan/ethnology, Logistic Models, Longitudinal Studies, Male, Nursing Homes/utilization, Residence Characteristics, Socioeconomic Factors
AbstractPlace of death is an indicator of health service utilization at the end of life and differs according to cause of death. Asian Americans may have a higher percentage of hospital deaths than Caucasian Americans, yet reasons for this finding are unclear. This study examined distribution of place of death and the associations between place and cause of death in elderly Japanese-American men in a longitudinal cohort: the Honolulu Heart Program and Honolulu-Asia Aging Study. Data collected between 1991 and 1999 on 1,352 men aged 73 to 99 at death were analyzed for associations between cause-of-death characteristics and hospital, home, or nursing home location of death. Fifty-nine percent of men died in hospitals, 23% died at home, and 18% died in nursing homes. Of the dementia-related deaths, 43% occurred in hospitals (vs 16% in a national study), 37% occurred in nursing homes (vs 67% in a national study), and 20% occurred at home. Of the stroke deaths, 53% occurred in hospitals, 40% were in nursing homes, and 7% occurred at home. Of the cancer deaths, 53% occurred in hospitals, 34% occurred at home, and 13% were in nursing homes. Traditional family obligation to care for elderly people at home and inability to access care for dementia may account for the greater rate of hospital death and lower rate of nursing home deaths in this cohort. Attitudes of elderly Japanese Americans and their families regarding place of care at the end of life, particularly in the setting of dementia, merit future study.
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