Death is 'core business' of Scottish hospitals, university study finds

Almost one in three hospital patients in Scotland will die within a year, and nearly one in 10 will die during their time in hospital, a study has found.

The Glasgow University report says the findings suggest that part of the "core business" of hospitals is people who are nearing the end of their lives.

The research team studied 10,000 people who were in 25 Scottish hospitals on one day - 31 March, 2010.

In total 3,098 patients, almost 31%, died within 12 months.

The study found that 9% died during their admission.

Older patients were more likely to die, and men were more likely to die than women.

Just over half of all male patients over the age of 85 died within the year.

Lead author Professor David Clark said: "I think what this paper really shows us is that what we call 'acute' hospitals really have, as part of their core business, the care of people who are coming to the end of their lives.

"The key message for me is how, as organisations, hospitals start to think more widely about the implications of that."

The likelihood of dying in hospital has been rising, despite the fact that surveys suggest most people would like to die at home.

Ward assessments

A recent international comparison of 34 countries by the University of Auckland found that 59% of all Scottish deaths occur in hospital, and a similar number in England and Wales.

It means British hospitals rank among the top 10 countries with the greatest number of deaths in a hospital setting.

Professor Clark, who is based at Glasgow University's Dumfries campus, said the next step was to work out how to identify those who were most likely to be nearing the end of their lives.

"A study like this is looking retrospectively," he said. "The key challenge is how to identify people prospectively; on admission to hospital or when they're first being assessed in the initial ward round. I think that's now where we should focus our energy.

"That's very tricky, of course. Starting those difficult conversations about end of life needs and wants is challenging work for family members and for professionals but I think the study shows there is an opportunity in hospital to start that conversation."

The report was published in the journal Palliative Medicine.