Why study death? - An analysis of eight years

Abstract

Objectives: To analyze the causes of death and factors associated with the death of patients from one family practice. Type of study: Descriptive Location: USF Horizonte, Matosinhos, Portugal Population: Patients registered with one family doctor between 2000 and 2007. Methods: The data were abstracted from clinic records using the Piloto 32®, SAM® and SAPE® electronic medical record systems. Socio-demographic variables and factors related to the death of the patients were analyzed using an Excel electronic spreadsheet. Results: Over an eight year period, 106 deaths were recorded giving a mortality rate of 8.7 deaths per 1000 patients per year. Of these, 62.2% of the patients were male. The median age was 71.6 years. Most were retired (79.2%) and most were married (50.9%) at the time of death. The place of death was known in 92.4% of cases. Of these, 53.1% died in hospital and 40.8% died at home. Limitation in activities of daily living (ADL) was recorded among 58.4% of patients before their death. A primary caregiver was identified in 90.6% of cases. The caregiver was a family member in 55.7% of cases. A cause of death was unknown in 8.5% of cases. Neoplasm was recorded as the cause of death in 47.7% of cases. Discussion: These results reveal deficiencies in the clinical recording of information about the death of patients and in the reporting of deaths. The demographic characteristics of this population are similar to those found in other published studies of mortality in primary care from Spain and Israel. The distribution of care among family and non-family caregivers is similar. The major differences between this population and others lie in the causes of death. Neoplasm was the most common cause of death and not cardiovascular disease, as has been found in other studies.