Institutionalised dying in Germany. Trends in place of death distribution: home, hospitals and nursing homes

The aim of this study is to identify the degree of institutionalised dying and to assess the differentiation between place of death, be it at a hospital, in a nursing home or at home (with/or without home care), as well as to illustrate trends in the place of death distribution. Process-produced routine data of the deaths of patients insured with the statutory health insurance Gmunder Ersatzkasse (GEK, n = 59,922) are used to calculate distributions of the deceased population (a parts per thousand yenaEuro parts per thousand 30 years old) from 2000-2009. In 2009, about 248,000 (29 %) and 598,000 (71 %) people in Germany died at home and in an institution, respectively. During the last 10 years the degree of institutionalised dying has increased by 6 percentage points. Women die more frequently in institutions than men (74 % compared to 67 %). For older age groups, dying in nursing homes becomes more prominent than dying in hospitals. The discrepancy between the preferred (at home) and empirically ascertained (institutions) place of death could increase even further as a result of the demographic as well as disease-specific developments in Germany.