• Monica Beccaro, Massimo Costantini, Paolo Giorgi Rossi, Guido Miccinesi, Maria Grimaldi, Paolo Bruzzi, and ISDOC Study Group.
• Unit of Clinical Epidemiology, National Cancer Institute, Largo Rosanna Benzi, 10, 16132, Genoa, Italy.
• J Epidemiol Community Health. 2006 May 1;60(5):412-6.

ObjectiveTo describe actual and preferred place of death of Italian cancer patients and to analyse the preferences met regarding the place of death.DesignMortality follow back survey of 2000 cancer deaths, identified with a two stage probability sample representative of the whole country. Information on patients' experience was gathered from the non-professional caregiver with an interview. A section of the interview covered information on the actual and preferred place of death of the patients.Setting30 Italian local health districts randomly selected after stratification in four geographical areas.Participants1900 of 2000 (95.0%) caregivers of cancer deaths identified.Main Outcome MeasuresPrevalence of actual and preferred places of death.ResultsValid interviews were obtained for 66.9% (n = 1271) of the caregivers. Place of death was home for 57.9% of Italian cancer patients, hospital for 34.6%, hospice for 0.7%, nursing home for 6.5%, and ambulance for 0.4%. Wide and significant differences within Italy were seen (home deaths ranged between 94.0% in the south and 28.2% in the north east). Home was the preferred place of death for 93.5% of patients that expressed a preference, with minimal differences within the country (between 89.5% and 99.0%). Overall 67.1% of the sample died in the place where they preferred to die.ConclusionsPolicymakers should encourage health services to focus on ways of meeting individual preferences on place of death. As home was the preferred place of death for most cancer patients, effective programmes to enable the patients to remain at home should be implemented.

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