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Variations in death notification of nursing home residents to Australian Coroners
  1. Joseph Elias Ibrahim1,
  2. Chebiwot Kipsaina1,
  3. Cathy Martin2,
  4. David Leo Ranson3,
  5. Lyndal Bugeja1
  1. 1 Department of Forensic Medicine, Health Law and Ageing Research Unit, Monash University, Melbourne, Victoria, Australia
  2. 2 Department of Epidemiology and Preventive Medicine, The Alfred Centre, Monash University, Melbourne, Victoria, Australia
  3. 3 Victorian Institute of Forensic Medicine, Forensic Services, Southbank, Victoria, Australia
  1. Correspondence to Professor Joseph Elias Ibrahim, Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Melbourne, VIC 3006, Australia; joseph.ibrahim{at}monash.edu

Abstract

Objectives To examine the impact of changes to the reporting requirements in coronial legislation on the nature and frequency of nursing home resident deaths reported to Coroners.

Design National retrospective study of a population cohort of nursing home resident deaths.

Setting Accredited Australian nursing homes between July 2000 and June 2013.

Participants Residents who died in nursing homes accredited by the Aged Care Standards and Accreditation Agency reported to Coroners.

Main outcome measures We explored three death-reporting models in the nursing home setting: comprehensive model, selective ‘mechanism of death’ model and selective ‘age of death’ model. These models were examined by manner of death subgroups: natural, falls-related and other external causes using the outcome measure of deaths notified to the Coroner per 1000 residents. We used an interrupted time series analysis using generalised linear regression with a negative binomial probability distribution and a log link function.

Results The comprehensive model showed the proportion of reportable deaths due to natural causes far exceeded those from falls and other external cause. In contrast, the selective notification models reduced the total number of reportable deaths. Similarly, the selective ‘age of death’ model showed a decline in the reportable external cause deaths.

Conclusions Variation in the causes, locations and ages of persons whose deaths are legally required to be notified to Coroners impacts the frequency and nature of deaths of nursing home residents investigated by Coroners. This demonstrates that legislation needs to be carefully framed and applied to ensure that the prevention mandate of Coroners in Australia is to be achieved.

  • older people
  • residential institution
  • mortality

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Footnotes

  • Contributors JEI is the senior author and contributed to the conception and development of ideas, acquisition of data, drafting and critical revision of the article draft, and final approval of the version to be published. CK contributed to the acquisition and interpretation of data, drafting the article and final approval of the version to be published. CM contributed to the analysis and interpretation of data, drafting and critical revision of the article draft, and final approval of the version to be published. DLR contributed to the design, drafting and critical revision of the article draft, and final approval of the version to be published. LB contributed to the conception, development of ideas, acquisition and interpretation of data, drafting and critical revision of the article draft, and final approval of the version to be published. All authors contributed substantially to the intellectual substance of the manuscript and are in full agreement regarding its content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Justice Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unpublished data are not available as our ethics approval does not permit us to do so.

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