Urbanization and place of death for the elderly: a 10-year population-based study

OBJECTIVES: To explore the association between the place of death and the level of urbanization within the communities where the elderly were residing at the time of their death. METHODS: A retrospective, population-based, cross-sectional study set in Taiwan, involving a total of 697,814 eligible deaths occurred between 1995 and 2004, among elderly people (aged 65 years or above). RESULTS: After adjusting for other factors, the multilevel logistic regression analyses showed that home death was associated with lower levels of urbanization; as compared with participants living in the highest urbanization level (level 1), the respective adjusted odds of dying at home were 1.600, 2.769, 3.774, 4.481, 4.003 and 4.717 times for those living in the areas from the second highest to the lowest urbanization levels (levels 2-7). CONCLUSIONS: After adjusting for other socio-demographic, clinical and healthcare factors, the place of death has a significant association with the level of urbanization among the elderly.