In 2017, the United States returned to a trend that had been gone for more than half a century. Indeed, deaths from natural causes now occur more at home than in hospital. This is a trend that should continue.
A duo of American researchers published a study in the New England Journal of Medicine December 12, 2019. The document recalls that between 2003 and 2017, no less than 35.2 million people died of natural causes in the United States. In 2017, 29.8% of natural deaths occurred in hospital and 30.7% intervened at home.
Obviously the gap is very small. However, this is the first time since the middle of the 20th century that such a trend had not been observed! According to researchers, Americans prefer to die at home rather than in an adapted establishment (hospital, retirement home, etc.). In France, this trend does not exist. Indeed, INSEE indicates that in 2018, 610,000 people died of natural cause. Of these, 53% died in a hospital (or other) and 24% at home.
Today, no less than 45% of the elderly in the United States have completed advance directives. These specify that doctors must not take measures to prolong the life of patients. In addition, more people are benefiting – thanks to the Medicare health insurance system – from palliative care at home, a 4.5% increase between 2016 and 2017. Moreover, the leaders of the study believe that this trend should continue in the years to come.
You should know that, in any case, the system is designed so that patients covered by Medicare do not stay too long in the hospital. According to the study, establishmentsreceive financial incentives send patients home more quickly. Thus, patients who are sometimes very ill (terminal phase) are entrusted to their families, relatives who are absolutely untrained. It is a terrible burden for the family . According to the study, loved ones may not understand what dying at home entails. These should be permanently available and be aware of how to manage the different symptoms (pain, shortness of breath, confusion).
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