Place of death, the location or setting in which an individual dies, is an important indicator for end-of-life care. With the number of Australians aged 85 years and over expected to double to more than 1 million people by 2042 (ABS, 2018), the importance of information on place of death from an economic and health service provision perspective will continue to grow. End-of-life care is a focus for all levels of government, with the 2018 National Palliative Care Strategy focused on ensuring the highest possible level of palliative care is available to all people, and the Palliative Care Outcomes Collaboration focused on improving palliative care patient and carer outcomes.
Despite the value of place of death data, there are currently no nationally consistent systems in place to accurately monitor statistics relating to place of death in Australia (Productivity Commission, 2017). The Australian Productivity Commission highlighted this as a data gap and recommended the establishment of a “national minimum data set for end of life care (including collecting and publishing linked information on place of death, primary and secondary diagnoses and details of service provision at time of death).” The Australian Hospital Statistics report produced by the Australian Institute of Health and Welfare (AIHW) currently provides numbers of deaths in hospitals and the National Coronial Information System maintains place of death for coroner referred deaths. However, there remains a large proportion of deaths which are not represented in those collections.
Information on place of death is collected through the Civil Registration system on either a Death Registration Form or the Medical Certificate of Cause of Death. While this information is provided to the ABS by the Registries of Births, Deaths and Marriages (RBDMs), the data is mostly collected and reported in free text form, with significant variations in format and quality preventing its use in statistical outputs thus far.
The value of a place of death indicator on the national mortality dataset is clear. It could provide insights into end-of-life care transitions associated with particular diseases or conditions, and it could highlight end-of-life issues particular to certain population sub-groups or those living in particular regions. Given the increasing importance of this information, the ABS commenced a pilot project to examine ways of corralling source data into meaningful and usable information.
This paper provides information on how this project was conceptualised and how data was coded and analysed. Initial results are presented with an aim to assess the quality of the outputs and the feasibility of including place of death as an integrated part of the national mortality dataset into the future.