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ContextOver the past century, nursing homes and hospitals increasingly have become the site of death, yet no national studies have examined the adequacy or quality of end-of-life care in institutional settings compared with deaths at home.ObjectiveTo evaluate the US dying experience at home and in institutional settings.Design, Setting, and ParticipantsMortality follow-back survey of family members or other knowledgeable informants representing 1578 decedents, with a 2-stage probability sample used to estimate end-of-life care outcomes for 1.97 million deaths from chronic illness in the United States in 2000. Informants were asked via telephone about the patient's experience at the last place of care at which the patient spent more than 48 hours.Main Outcome MeasuresPatient- and family-centered end-of-life care outcomes, including whether health care workers (1) provided the desired physical comfort and …