The rise of home death in the COVID-19 pandemic: a population-based study of death certificate data for adults from...

Area of Science:

• Public Health
• Mortality Studies
• Gerontology

Background:

• The COVID-19 pandemic significantly impacted global health systems and mortality patterns.
• Understanding changes in place of death is crucial during global health crises.
• Previous trends in dying places pre-pandemic provide a baseline for comparison.

Purpose of the Study:

• To examine trends in the place of death for adults in 32 countries.
• To compare dying place patterns during the initial COVID-19 pandemic years (2020-2021) with the pre-pandemic period (2012-2019).
• To analyze variations in these trends by country, sex, age group, and underlying cause of death.

Main Methods:

• Data on adult deaths from 2012-2021 were collected from 32 countries.
• Place of death was categorized as 'home,' 'hospital or health institution,' 'other defined,' or 'ill-defined.'
• Analysis included aggregate data, sex, age groups, and causes of death (cancer, dementia, COVID-19).

Main Results:

• Over 100 million deaths were analyzed; 30.8% occurred at home.
• The percentage of home deaths increased from 30.1% (2012-2013) to 32.2% (2020-2021).
• Home deaths rose in 23 countries, with a greater increase observed in women and cancer deaths.

Conclusions:

• The COVID-19 pandemic was associated with an increase in home deaths, though this varied significantly.
• Differences by sex may relate to end-of-life care planning and avoidance of hospital admissions.
• The rise in home deaths for cancer patients could be linked to predictable trajectories and palliative care integration.