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A retrospective review of death review forms and medical records was conducted in two pediatric palliative care services in Sydney, Australia, involving 486 patients who died between January 2017 and May 2024). Hospital was the most common LOD (49.8%), then home (28.4%) and hospice (21.0%). At the last documented LOD conversation, 36.2% of families preferred home, 28.6% hospice and 26.4% hospital. Preferred LOD outcomes were achieved for 87.7% of families, although 21% who preferred a home death did not achieve this. Preferred and actual LODs of home were significantly associated with having a community palliative care referral and palliative care home visit. The findings highlight the importance of enabling families to plan for their child\u2019s LOD, and ensuring preferences are documented and communicated across health services.<\/jats:p>","DOI":"10.1177\/00302228251415138","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T06:41:27Z","timestamp":1767940887000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Actual and Preferred Location of Death for Children Known to a Palliative Care Service"],"prefix":"10.1177","author":[{"given":"Victoria","family":"Sun","sequence":"first","affiliation":[{"name":"Sydney Children\u2019s Hospital Network"},{"name":"University of New South Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6128-9528","authenticated-orcid":false,"given":"Sandra","family":"Coombs","sequence":"additional","affiliation":[{"name":"Sydney Children\u2019s Hospital Network"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0253-3503","authenticated-orcid":false,"given":"Nicole","family":"Armitage","sequence":"additional","affiliation":[{"name":"Sydney Children\u2019s Hospital Network"},{"name":"University of New South Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meaghan","family":"Dowling","sequence":"additional","affiliation":[{"name":"Sydney Children\u2019s Hospital Network"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-7844","authenticated-orcid":false,"given":"Tiina","family":"Jaaniste","sequence":"additional","affiliation":[{"name":"Sydney Children\u2019s Hospital Network"},{"name":"University of New South Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.04.028"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12131"},{"key":"e_1_3_4_4_1","volume-title":"New South Wales and the COVID-19 pandemic from 2020 to 2022","author":"Australian Bureau of Health Information","year":"2023","unstructured":"Australian Bureau of Health Information. 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