Background With growing emphasis on palliative care for neurodegenerative conditions, understanding trends in place of death helps improve quality of end-of-life care for people with Parkinson’s disease and related disorders (PDRDs), focusing allocation of resources and training and identifying inequalities. Objectives Review national and regional place of death trends for people with PDRD including pre- and post-pandemic trends. Methods Mortality data for England and Wales (March 2018 and July 2022) were analysed with summary statistics and interrupted time series, exploring place of death for those who died with PDRD, with and without coexisting dementia, with reference to all deaths in England and Wales. Results Of 2,415,566 adult deaths, 56,790 included mention of PDRD. Hospital deaths were most common in people with PDRD (39.17%), followed by care homes (38.84%). People with PDRD were half as likely to die in hospice compared with the general population (2.03 vs 4.94%). Proportion of care home deaths fell significantly after March 2020 (40.6–37%, P = 0.035). Regionally, London was an outlier with a lower proportion of deaths occurring in care homes with a higher proportion of hospital deaths. Conclusion Place of death for people with PDRD is changing, with more hospice and home deaths. People with PDRD, particularly those with co-existent dementia, are less likely to access inpatient hospice care than the general population. Since the COVID-19 pandemic, the proportion of care home deaths has reduced significantly with an increase in home deaths, with implications for service and resource allocation.

中文翻译：

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英格兰和威尔士帕金森病及相关疾病的死亡地点：大流行后趋势及对护理计划的影响

背景 随着对神经退行性疾病的姑息治疗越来越重视，了解死亡趋势有助于提高帕金森病及相关疾病 (PDRD) 患者的临终护理质量，重点分配资源和培训并识别不平等现象。目标 审查国家和地区 PDRD 患者的死亡地点趋势，包括大流行前和大流行后的趋势。方法 采用汇总统计和中断时间序列对英格兰和威尔士的死亡率数据（2018 年 3 月和 2022 年 7 月）进行分析，参考英格兰和威尔士的所有死亡，探索患有 PDRD 的患者（无论是否患有痴呆症）的死亡地点。 。结果 在 2,415,566 例成人死亡中，有 56,790 例提到了 PDRD。 PDRD 患者中医院死亡最常见 (39.17%)，其次是疗养院 (38.84%)。 PDRD 患者在临终关怀中心死亡的可能性是普通人群的一半（2.03% vs 4.94%）。 2020 年 3 月后，疗养院死亡比例显着下降（40.6-37%，P = 0.035）。从地区来看，伦敦是一个例外，疗养院的死亡比例较低，而医院死亡的比例较高。结论 PDRD 患者的死亡地点正在发生变化，临终关怀和家庭死亡人数增多。 PDRD 患者，特别是同时患有痴呆症的患者，与普通人群相比，获得住院临终关怀护理的可能性较小。自 COVID-19 大流行以来，疗养院死亡人数的比例显着下降，而家庭死亡人数增加，这对服务和资源分配产生了影响。