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Change in the Proportion of Death at Home during the COVID-19 Pandemic and Its Associated Factors in the Municipality
Yu Sun1,2,3, Masao Iwagami1,3, Ryota Inokuchi3
1Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
JMA Journal
|May 9, 2024
Summary
The COVID-19 pandemic significantly increased home deaths, especially in populated areas. Enhanced home care support clinics and hospitals (HCSCs) are vital for end-of-life care at home.
Area of Science:
- Public Health
- Gerontology
- Epidemiology
Background:
- The COVID-19 pandemic may have increased home deaths due to healthcare system strain.
- Hospital bed shortages and visitation restrictions likely contributed to this trend.
Purpose of the Study:
- To analyze changes in the proportion of home deaths before and after the COVID-19 pandemic.
- To identify factors associated with the increase in home deaths.
Main Methods:
- Utilized nationwide data (2015-2021) to track home death proportions.
- Employed multivariable linear regression on municipal-level data (2019-2021) to assess influencing factors.
- Independent variables included pre-pandemic home death rates, medical/LTC resources, population density, and COVID-19 cases.
Main Results:
- Home deaths rose from 13.6% in 2019 to 17.2% in 2021.
- Increased home deaths correlated positively with enhanced home care support clinics and hospitals (HCSCs), home-visiting nurses, population density, and COVID-19 cases.
- Higher availability of long-term care (LTC) beds and a higher 2019 home death proportion were negatively associated with the increase.
Conclusions:
- A significant rise in home deaths occurred during the COVID-19 pandemic.
- Densely populated areas with high COVID-19 case counts saw a more pronounced increase.
- Enhanced HCSCs are critical for supporting home-based end-of-life care.
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