{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T09:55:54Z","timestamp":1776074154672,"version":"3.50.1"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"unspecified","delay-in-days":102,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951526102193_sec1a\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Hospices represent the cornerstone of modern palliative services. However, population-level data on hospice utilization and characteristics of patients dying in hospice remain limited to examine national temporal trends in hospice deaths in Italy from 2011 to 2022, with a focus on the underlying causes of death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102193_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a nationwide, population-based retrospective study using official mortality data from the Italian National Institute of Statistics. All deaths registered in Italy between 2011 and 2022 were included. Hospice deaths were identified as those occurring in licensed hospice facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102193_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hospice beds increased from 1,681 in 2011 to 3,419 in 2022, while hospice deaths more than doubled from 19,179 (3.2% of all deaths) to 43,972 (6.2%). The mean age of hospice deaths rose from 74.0 to 76.6\u00a0years. Among patients dying in hospice, neoplasms remained the leading cause of death but declined from 87.0% in 2011 to 73.8% in 2022, while cardiovascular deaths increased from 6.2% to 9.5%, neurological from 1.2% to 3.4%, and respiratory from 1.0% to 2.5%. The proportion of national neoplasm deaths occurring in hospice reached approximately 20% in 2022. Similarly, the proportion of non-neoplasm hospice deaths tripled (0.6\u20132.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951526102193_sec4d\">\n                    <jats:title>Significance of the results<\/jats:title>\n                    <jats:p>Between 2011 and 2022, hospice deaths in Italy more than doubled, reflecting substantial progress in expanding access to palliative care. The gradual increase in non-neoplasm hospice deaths suggests a shift toward greater inclusivity, although neoplasm remains predominant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951526102193","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T09:08:12Z","timestamp":1776071292000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Temporal trends in hospice deaths and causes of death in Italy, 2011\u20132022: A nationwide population-based study"],"prefix":"10.1017","volume":"24","author":[{"given":"Edoardo","family":"Varratta","sequence":"first","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore Facolt\u00e0 di Medicina e Chirurgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Iurlaro","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore Facolt\u00e0 di Medicina e Chirurgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giada","family":"Minelli","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanita"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Guaita","sequence":"additional","affiliation":[{"name":"Istituto Superiore di Sanita"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myriam","family":"Macaluso","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Beatrice","family":"Zazzara","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore Facolt\u00e0 di Medicina e Chirurgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3400-4491","authenticated-orcid":false,"given":"Graziano","family":"Onder","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Cattolica del Sacro Cuore Facolt\u00e0 di Medicina e Chirurgia"},{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"S1478951526102193_ref19","unstructured":"World Health Organization (2016) International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) . Available at https:\/\/icd.who.int\/browse10\/2016\/en (accessed 6 October 2025 )."},{"key":"S1478951526102193_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afad175"},{"key":"S1478951526102193_ref7","volume-title":"Cause Di Morte: Anno 2022","year":"2024"},{"key":"S1478951526102193_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951519001111"},{"key":"S1478951526102193_ref8","unstructured":"Italian Law 38\/2010 (2010) Disposizioni per garantire l\u2019accesso alle cure palliative e alla terapia del dolore. Gazzetta Ufficiale della Repubblica Italiana , 19 March."},{"key":"S1478951526102193_ref1","volume-title":"Rapporto Hospice 2023","year":"2023"},{"key":"S1478951526102193_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.08.026"},{"key":"S1478951526102193_ref3","first-page":"64","article-title":"How to conduct research in palliative care? A perspective from Italy","volume":"60","author":"Cocchi","year":"2024","journal-title":"Annali dell\u2019Istituto Superiore Di Sanit\u00e0"},{"key":"S1478951526102193_ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.11146"},{"key":"S1478951526102193_ref17","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph181910345"},{"key":"S1478951526102193_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-023-02426-7"},{"key":"S1478951526102193_ref13","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0049"},{"key":"S1478951526102193_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16840"},{"key":"S1478951526102193_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2020-002719"},{"key":"S1478951526102193_ref2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-7-66"},{"key":"S1478951526102193_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0000000000000729"},{"key":"S1478951526102193_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/0269216315585064"},{"key":"S1478951526102193_ref9","unstructured":"Italian Ministry of Health (2023) Annuario Statistico del Servizio Sanitario Nazionale: Assetto organizzativo, attivit\u00e0 e fattori produttivi del SSN . Available at https:\/\/www.salute.gov.it\/new\/it\/pubblicazione\/annuario-statistico-del-servizio-sanitario-nazionale-anno-2023\/ (accessed 6 October 2025 )."},{"key":"S1478951526102193_ref18","first-page":"252","article-title":"Palliative care as a fundamental human right: Where are we at in Italy?","volume":"175","author":"Volonnino","year":"2024","journal-title":"Clinical Therapeutics"},{"key":"S1478951526102193_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.8981"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951526102193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T09:08:17Z","timestamp":1776071297000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951526102193\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":20,"alternative-id":["S1478951526102193"],"URL":"https:\/\/doi.org\/10.1017\/s1478951526102193","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e103"}}