• Cecilia Håkanson, Joakim Öhlén, Lucas Morin, and Joachim Cohen.
• Palliative Research Centre and Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden Department of Neurobiology, Care science and Society, Karolinska Institutet, Huddinge, Sweden cecilia.hakanson@esh.se.
• Scand J Public Health. 2015 Nov 1; 43 (7): 744-51.

AimsThe aims of this study were to examine, on a population level, where people die in Sweden, and to investigate associations between place of death and underlying cause of death, socioeconomic and environmental characteristics, with a particular interest in people dying from life-limiting conditions typically in need of palliative care.MethodsThis population-level study is based on death certificate data for all deceased individuals in Sweden in 2012, with a registered place of death (n=83,712). Multivariable logistic regression was performed to investigate associations between place of death and individual, socioeconomic and environmental characteristics.ResultsThe results show that, in 2012, 42.1% of all deaths occurred in hospitals, 17.8% occurred at home and 38.1% in nursing home facilities. Individuals dying of conditions indicative of potential palliative care needs were less likely to die in hospital than those dying of other conditions (OR = 0.73; 95% CI = 0.70-0.77). Living at home in urban areas was associated with higher likelihood of dying in hospital or in a nursing home (OR = 1.04 and 1.09 respectively). Educational attainment and marital status were found to be somewhat associated with the place of death.ConclusionsThe majority of deaths in Sweden occur in institutional settings, with comparatively larger proportions of nursing home deaths than most countries. Associations between place of death and other variables point to inequalities in availability and/or utilization of health services at the end of life.© 2015 the Nordic Societies of Public Health.

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