More Patients With Heart Disease Die at Home Than in Hospital

Nearly a third of U.S. heart patients die at home, which is more than the number who die in the hospital, according to a new study.

Researchers examined data on more than 12 million heart disease patients who died between 2003 and 2017. They looked at whether the deaths occurred in a hospital, home, nursing or long-term care facility, inpatient hospice, or elsewhere (outpatient medical facility, emergency department, or dead-on-arrival at the hospital).

The number of heart disease deaths in the hospital fell from nearly 331,000 in 2003 to nearly 235,000 in 2017. Home deaths, meanwhile, rose from almost 193,000 to over 265,000, accounting for about 31% of heart disease deaths in 2017.

"When I talk to my patients about what's most important to them as they begin to reach the end of life, so many of them tell me they want to spend their last moments surrounded by the familiarity of home," said study author Dr. Haider Warraich, a cardiologist at Brigham and Women's Hospital in Boston.

Patients in underserved racial and ethnic groups were more likely to die in the hospital and less likely to die at home, according to the findings.

Heart disease is the leading cause of death worldwide, but little is known about where patients die, according to the researchers.

"Understanding where patients die can help us determine how we can deliver care to them and what services they'll require in those settings," Warraich explained in a hospital news release.

While the data show where patients died, it doesn't reveal what their last days or weeks of life were like, their wishes and whether their place of death reflected those wishes, Warraich noted.

"Cardiology has lagged behind other specialties in focusing on end-of-life care, but we're now seeing more interest in this important area," he said.

"We're seeing that more people are dying at home than at any other location, but we need to better understand what that experience is like so that we can focus our energy on the needs of our patients," Warraich said.

The study was recently published in the Journal of the American College of Cardiology.

Source: Brigham and Women's Hospital, news release, October 2019.