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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

Janssen, Daisy J.A.; Rechberger, Simon; Wouters, Emiel F.M.; Schols, Jos M.G.A.; Johnson, Miriam J.; Currow, David C.; Curtis, J. Randall; Spruit, Martijn A.

Authors

Daisy J.A. Janssen

Simon Rechberger

Emiel F.M. Wouters

Jos M.G.A. Schols

David C. Currow

J. Randall Curtis

Martijn A. Spruit



Abstract

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.

Journal Article Type Article
Publication Date 2019-07
Journal Journal of Clinical Medicine
Print ISSN 2077-0383
Electronic ISSN 2077-0383
Publisher MDPI
Peer Reviewed Peer Reviewed
Volume 8
Issue 7
Article Number 922
APA6 Citation Janssen, D. J., Rechberger, S., Wouters, E. F., Schols, J. M., Johnson, M. J., Currow, D. C., …Spruit, M. A. (2019). 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. Journal of Clinical Medicine, 8(7), https://doi.org/10.3390/jcm8070922
DOI https://doi.org/10.3390/jcm8070922
Keywords Mortality; Death; Death certificates; Palliative care; Delivery of health care; Multi-morbidity; Ageing
Publisher URL https://www.mdpi.com/2077-0383/8/7/922
Additional Information © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Copyright Statement
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license
http://creativecommons.org/licenses/by/4.0/).





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