Abstrakt
Background: This study examines disparities in the place of death in patients in the United States with diabetes mellitus (DM) using data from the CDC WONDER (Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research) database covering a 22-year period (1999-2020). Looking at age, gender, ethnicity, and census location, among other variables, the study aims to understand trends and determinants of mortality at home or hospice care compared to mortality at a medical or nursing facilities.
Materials and methods: An online freely accessible mortality database, CDC WONDER database, was used to collect information regarding DM-related mortality, using the International Classification of Diseases, 11th Revision (ICD-11) code range E10-E14. To investigate patterns in location of death, the research population was split by census regions, racial categories, age groups, and gender.
Statistical techniques such as univariate logistic regression and graphical representations were employed. Results: Based on a study of 1,674,724 DM-related deaths, medical or nursing facilities recorded higher deaths (1,041,602) compared to home or hospice deaths (572,567).
The highest number of deaths in home or hospice setting was recorded for the age group of 75-84 years (146,820), male gender (324,325), Census Region 3 (South) (225,636), and white race (458,690). Among the patients with death at home or a hospice center; the odds were highest for the age group of 55-64 years, male gender, Census Region 4 (West), and American Indian or Alaska Native race.
Discussion: The results showed a general upward trend in DM patients' deaths at home and in hospice care in the United States. Males, white people, and those in the age group of 75-84 years notably had the highest death rates.
Regional differences also came into play, with the South showing the biggest trend in mortality. To better understand the underlying causes of these changes and to increase at-risk groups' access to healthcare facilities, more research is required.
Conclusion: There is an overall rising trend in home and hospice deaths in the United States for patients with DM, but with a steady dip between the years 2005 and 2010. Patient deaths from DM were categorized by age groups, gender, race, and census regions.
The highest mortality trends are exhibited in whites, males, and those aged 75-84 years. Out of the census regions, the South has the highest mortality trend.
Further studies could be carried out to determine the reasons for the rising trends in home or hospice deaths in the aforementioned groups and how to provide these groups with better access to healthcare facilities.