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You get 3 options, called oaths.
1st option - Save and load manually anywhere whenever. When you die, you can respawn.
2nd option - Auto saves can be loaded only, you can't save and load manually (no save scumming). When you die, you can respawn.
3rd option - Auto saves only and when you die, that's it. You lose everything and must reroll a new character because respawning is disabled.
You have 90 days grace period before you take any penalties from dying and respawning. After which, when you die, you drop some money and can also take a hit to your skills. You revive with 33% max HP and 0 MP and stamina at your chosen respawn point. You can go collect your drop loot if you return to it before the area resets.
As mentioned, in permadeath mode, if you die, that is it. However, if you're stamina is above 50%, you can survive an otherwise fatal blow and go into negative health. It can be the difference between escaping to live another day or having your run end in tragedy.
Don't know where i heard this, but somewhere around 3 day's i think?
Whenever the screen shakes and you hear a "WHRRR" event in the dialogue log, that's places being shifted around and regenerating again.
But sometimes items on the ground can just disappear when a new day starts too, depending on the location.