Home › Research › Health systems and care delivery
Assessment of changes in place of death of older adults who died from dementia in the United States, 2000–2014: a time-series cross-sectional analysis
Wei Xu, Changshan Wu, Jason M. Fletcher. BMC Public Health, 2020-06-10
Topic: Risk, prevention and care in population studies
Dementia decedents were more likely to die at home and other places and less likely to die at institutional settings over the study period. There was wide inter-state and temporal variability in the proportions of deaths at different places. Among state-level factors, availability of nursing home beds was positively associated with rates of nursing home/long term care deaths and negatively associated with rates of home deaths. Medicaid expenditure on institutional long term supports and services was positively associated with rates of nursing home/long term care deaths and negatively associated with rates of home deaths. Medicaid expenditure on home and community based services, however, had a positive association with rates of home deaths. There was a persistent shift in the place of death of dementia decedents from institutions to homes and communities. Increased investments in home and community based health services may help dementia patients to die at their homes. As home becomes an increasingly common place of death of dementia patients, it is critical to monitor the quality of end-of-life care at this setting.
Key findings
- Dementia decedents were more likely to die at home and other places and less likely to die at institutional settings over the study period.
- There was wide inter-state and temporal variability in the proportions of deaths at different places.
- Among state-level factors, availability of nursing home beds was positively associated with rates of nursing home/long term care deaths and negatively associated with rates of home deaths.
- Medicaid expenditure on institutional long term supports and services was positively associated with rates of nursing home/long term care deaths and negatively associated with rates of home deaths.
- Medicaid expenditure on home and community based services, however, had a positive association with rates of home deaths.
Why it matters
This analysis found a shift over time toward more dementia decedents dying at home and in communities rather than institutions, with state factors like nursing home bed availability and Medicaid spending linked to place of death. It concerns end-of-life care location, not treating, curing, or preventing Alzheimer's disease.
Study details
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC Public Health) |
| Journal's citation record | 3 / 4 | BMC Public Health: journal h-index 289 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 31 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.9 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 2 / 6 | Cited 3.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 14 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Jason M. Fletcher: h-index 55 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Wisconsin–Madison: institution h-index 1,518 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32522179) |
| Free to read | 2 / 2 | Free to read |
| Total | 42 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1186/s12889-020-08894-0
- PubMed: 32522179
- Original source →
- Free full text: BMC Public Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Xu, W., Wu, C., & Fletcher, J. M. (2020). Assessment of changes in place of death of older adults who died from dementia in the United States, 2000–2014: a time-series cross-sectional analysis. BMC Public Health. https://doi.org/10.1186/s12889-020-08894-0
Vancouver
Xu W, Wu C, Fletcher JM. Assessment of changes in place of death of older adults who died from dementia in the United States, 2000–2014: a time-series cross-sectional analysis. BMC Public Health. 2020. doi:10.1186/s12889-020-08894-0. PMID: 32522179.
BibTeX
@article{xu2020-32522179,
author = {Xu, Wei and Wu, Changshan and Fletcher, Jason M.},
title = {{Assessment of changes in place of death of older adults who died from dementia in the United States, 2000–2014: a time-series cross-sectional analysis}},
journal = {BMC Public Health},
year = {2020},
doi = {10.1186/s12889-020-08894-0},
pmid = {32522179},
url = {https://doi.org/10.1186/s12889-020-08894-0}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
2 studies in the alzhub library list this one in their references.
Related studies in Health systems and care delivery
Also tagged “care”
996 studies in the library carry the topic tag “care”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 996 tagged studies.