Were people who died at home less likely to attend hospital at the end of life during the Covid pandemic?

Categories: Data Insights, ADR Scotland, Health & wellbeing

31 January 2023

Previous Scottish Centre for Administrative Data Research (SCADR) analysis has demonstrated that deaths at home increased by over a third during the Covid-19 pandemic in Scotland. This increase continues as of January 2023. What is unclear is how and to what degree patterns of hospitalisation changed. This research explores whether people approaching the end of life were less likely to go to hospital.

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What we did

After discovering a large increase in deaths at home in Scotland during the Covid-19 pandemic, we applied to analyse linked death records held by National Records Scotland and health service data held by Public Health Scotland, including inpatient hospital records. This data linkage enabled analysis of hospitalisations for people in their final year of life. In this study we are comparing health service use differences, between the first year of the pandemic period (23rd March 2020 to 22nd March 2021) and the pre-pandemic period (23rd March 2015 to 22nd March 2020). The current work involves using descriptive statistics to summarise service use by people. We look separately at deaths in a hospital, in a care home, or at home (or another non-institutional setting, for example those in a road accident ) because changes in one place of death might help explain changes in other places.

Why it matters

Our study investigating service use in the last year of life during the pandemic provides insights into how the pandemic affected the services provided by the NHS and how it changed where people died. This is important for future planning of services, policy, and adapting to the increased number of people who died at home which has remained at an elevated level into 2023. By using administrative data we are able to look at the entirety of the population of people who died before and during the first year of the pandemic, and access information about their hospitalisations and other health services.

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