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Open AccessArticle

Clustering of 27,525,663 Death Records from the United States Based on Health Conditions Associated with Death: An Example of Big Health Data Exploration

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Department of Research & Education, CIRO, Centre of expertise for chronic organ failure, 6085NM Horn, The Netherlands
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Centre of Expertise for Palliative Care, Maastricht University Medical Centre (MUMC+), 6229HX Maastricht, The Netherlands
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Department of Health Services Research, Maastricht University, 6229GT Maastricht, The Netherlands
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Viscovery Software GmbH, 1130 Vienna, Austria
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Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229HX Maastricht, The Netherlands
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Department of Family Medicine, Maastricht University, 6229HA Maastricht, The Netherlands
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Wolfson Palliative Care Research Centre, Hull and York Medical School, University of Hull, Hull HU6 7RX, UK
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IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, NSW2007 New South Wales, Australia
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Cambia Palliative Care Center of Excellence, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA
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NUTRIM School of Nutrition and Translational Research in Metabolism, 6229ER Maastricht, The Netherlands
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REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, BE3590 Diepenbeek, Belgium
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(7), 922; https://doi.org/10.3390/jcm8070922
Received: 6 June 2019 / Revised: 19 June 2019 / Accepted: 21 June 2019 / Published: 27 June 2019
(This article belongs to the Section Epidemiology & Public Health)
Background: Insight into health conditions associated with death can inform healthcare policy. We aimed to cluster 27,525,663 deceased people based on the health conditions associated with death to study the associations between the health condition clusters, demographics, the recorded underlying cause and place of death. Methods: Data from all deaths in the United States registered between 2006 and 2016 from the National Vital Statistics System of the National Center for Health Statistics were analyzed. A self-organizing map (SOM) was used to create an ordered representation of the mortality data. Results: 16 clusters based on the health conditions associated with death were found showing significant differences in socio-demographics, place, and cause of death. Most people died at old age (73.1 (18.0) years) and had multiple health conditions. Chronic ischemic heart disease was the main cause of death. Most people died in the hospital or at home. Conclusions: The prevalence of multiple health conditions at death requires a shift from disease-oriented towards person-centred palliative care at the end of life, including timely advance care planning. Understanding differences in population-based patterns and clusters of end-of-life experiences is an important step toward developing a strategy for implementing population-based palliative care. View Full-Text
Keywords: mortality; death; death certificates; palliative care; delivery of health care; multi-morbidity; ageing mortality; death; death certificates; palliative care; delivery of health care; multi-morbidity; ageing
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Janssen, D.J.; Rechberger, S.; Wouters, E.F.; Schols, J.M.; Johnson, M.J.; Currow, D.C.; Curtis, J.R.; Spruit, M.A. Clustering of 27,525,663 Death Records from the United States Based on Health Conditions Associated with Death: An Example of Big Health Data Exploration. J. Clin. Med. 2019, 8, 922.

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