Factors Associated With Place of Death Among the Chinese Oldest Old

Abstract

Based on 6,444 deceased respondents ages 80 to 105 years from the first three waves of the Chinese Longitudinal Healthy Longevity Survey, the authors use multilevel modeling to examine how community development, individual sociodemographic characteristics, health conditions, and health resources affect place of death. Results show that 92% of Chinese oldest old die at home, with 7% dying in hospitals and 1% at institutions. Analyses indicate that residents from relatively developed communities in China tend to have a higher chance of hospital and/or institutional deaths; individuals with higher socioeconomic status (SES) and worsening health are more likely to experience hospital deaths; those who have pension and/or public and/or collective free medical services are more likely to die in hospitals and/or institutions. The authors also propose a theory about place of death consisting of three evolutionary stages, which might explain the disparity in patterns of place of death in different societies.