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The rise of home death in the COVID-19 pandemic

2024-02Artigo científico Acesso aberto
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dc.contributor.authorLopes, Sílvia
dc.contributor.authorBruno de Sousa, Andrea
dc.contributor.authorDelalibera, Mayra
dc.contributor.authorNamukwaya, Elizabeth
dc.contributor.authorCohen, Joachim
dc.contributor.authorGomes, Barbara
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.pblElsevier
dc.date.accessioned2024-05-17T00:39:49Z
dc.date.available2024-05-17T00:39:49Z
dc.date.issued2024-02
dc.descriptionFunding Information: This work is part of the EOLinPLACE Project, which has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No 948609). Publisher Copyright: © 2023 The Author(s)
dc.description.abstractBackground: During the coronavirus 2019 disease (COVID-19) pandemic, health systems had to respond to the needs of COVID-19 patients, while caring for patients with other life-threatening conditions. Pandemics, such as the COVID-19 pandemic, stir global health and mortality patterns. This is likely to include trends in dying places. In this paper, we examine trends in place of death for adults in 32 countries, comparing the initial COVID-19 pandemic years (2020–2021) with the eight years before the pandemic (2012–2019). Methods: Data on place of death for all adults (18 years and over) that died from 1 January 2012 to 31 December 2021 were requested (47 countries approached, 32 included). The classification of place of death varied widely between countries. “Home” was the most common category, the remaining category groups comprised “hospital or health institution”, “other defined”, and “ill-defined”. We analysed place of death data in an aggregate form, by sex, age group, and selected underlying causes of death (cancer, dementia, and COVID-19). Findings: The study included 100.7 million people (51.5% male, 68.0% with ≥70 years), 20.4% died from cancer and 5.8% from dementia; 30.8% of deaths took place at home. The percentage of home deaths rose from 30.1% in 2012–2013 to 30.9% in 2018–2019 and further to 32.2% in the pandemic (2020–2021). Home deaths increased during the pandemic in 23 countries. In most countries the rise was greater in women and cancer; age differences were not consistent. Interpretation: Our study shows that there was a rise in home deaths during the pandemic, but with variability across countries, sex, age, and causes of death. The sex difference observed in most countries may have several explanations, including more engagement of women in discussions about end of life care planning and hospital admission avoidance. A higher rise of home deaths among people dying of cancer may be explained by the more predictable disease trajectory compared to non-malignant conditions, as well as earlier and better integrated palliative care. Funding: This work is part of the EOLinPLACE Project, which has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No 948609).en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent545488
dc.identifier.doi10.1016/j.eclinm.2023.102399
dc.identifier.issn2589-5370
dc.identifier.otherPURE: 91146715
dc.identifier.otherPURE UUID: 3c453cd4-7715-4a67-bfc4-4639bda53fd2
dc.identifier.otherScopus: 85184069318
dc.identifier.otherWOS: 001203206700001
dc.identifier.otherPubMed: 38545089
dc.identifier.otherPubMedCentral: PMC10965402
dc.identifier.otherORCID: /0000-0002-6048-396X/work/159774839
dc.identifier.urihttp://hdl.handle.net/10362/167483
dc.identifier.urlhttps://www.scopus.com/pages/publications/85184069318
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAdult
dc.subjectCOVID-19
dc.subjectDeath certificates
dc.subjectMortality
dc.subjectPalliative care
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleThe rise of home death in the COVID-19 pandemicen
dc.title.subtitlea population-based study of death certificate data for adults from 32 countries, 2012–2021en
dc.typejournal article
degois.publication.titleeClinicalMedicine
degois.publication.volume68
dspace.entity.typePublication
rcaap.rightsopenAccess

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