• C A Clifford, D J Jolley, and G G Giles.
• Department of Psychiatry, University of Tasmania, Hobart.
• Med. J. Aust. 1991 Oct 7;155(7):446-51, 456.

ObjectiveTo describe where deaths occur in Victoria and to determine to what extent the probability of dying in certain institutions is associated with cause of death and sociodemographic variables.DesignDescriptive study of death certificates and multivariate analysis of 7697 deaths that occurred in a three-month period in 1988.SettingThe State of Victoria.Main Outcome MeasuresCause of death, age, sex, marital status, and socioeconomic status.ResultsMost deaths occurred in public hospitals (48%) followed by private homes (21%), nursing homes (14%) and private hospitals (9%). Only 2% of all deaths (90% from cancer) occurred in hospices. Women were more likely to die in a nursing home than were men (21% v. 8%) and less likely to die at home (17% v. 24%). The proportion of deaths increased with age in nursing homes and declined in private homes. Significant predictors of death in a public hospital were age and socioeconomic status; the probability diminished with increasing age and was lower for those in the upper third for socioeconomic status. Predictors for dying in a private home were age and marital status; the probability diminished with age and in the absence of a spouse.ConclusionsDeath as a hospice inpatient is comparatively rare in Victoria and the impact of hospice outpatient or domiciliary care on dying at home has yet to be established. Should death at home become a preferred option, the presence and ability of a spouse or other caregiver will be a significant factor.

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