Is home always the best and preferred place of death?

Place of death has become a key indicator of the quality of end of life care,1 2 underpinned by the conviction that most people would prefer to die at home.3 4 The institutional environment of acute hospital wards is considered an inappropriate and undesirable place in which to die,5 6 and there are concerns about poor quality of care.7 8 9 The need to reduce costs is a further incentive for reducing deaths in hospital.6 10 11 However, the evidence on patients’ preferences is unclear and conflicting. Regardless of preference, hospital will remain the most common place of death for the foreseeable future.6 12 Far from neglecting and disregarding the hospital as a site of terminal care, much greater thought and adequate resources must be directed to enabling hospitals to provide excellent support for dying patients and their families.