Deaths at home during COVID-19 in Scotland: Demographics, multimorbidity, and palliative care needs in population data
IntroductionDeaths at home increased by a third in Scotland during the pandemic period, yet little is known about the population who died at home. Policy towards supporting this increased number will benefit from understanding differences in the socio-demographic composition and clinical needs of th...
Saved in:
| Published in: | International journal of population data science Vol. 10; no. 1 |
|---|---|
| Main Authors: | , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Swansea University
20.10.2025
|
| Subjects: | |
| ISSN: | 2399-4908, 2399-4908 |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | IntroductionDeaths at home increased by a third in Scotland during the pandemic period, yet little is known about the population who died at home. Policy towards supporting this increased number will benefit from understanding differences in the socio-demographic composition and clinical needs of those dying at home following the pandemic. ObjectivesTo describe the population who died at home in Scotland during the first year of the Covid-19 pandemic and compare them to the population of decedents five years prior, in terms of demographic and clinical characteristics and estimated palliative care needs. Demographic characteristics included age, sex assigned at birth, marital status, the area-based Scottish Index of Multiple Deprivation (SIMD) and the Scottish urban-rural indicator. MethodsRetrospective cohort study of death registrations for Scottish decedents between March 2015 and March 2021, with the 12-month period from 2020-03-23 defined as the pandemic period. Death registrations were linked to 10 years of inpatient admissions to identify comorbid conditions and compute the Elixhauser Comorbidity Index (EI). Palliative care needs were estimated from underlying and contributory causes of death using ICD-10 codes. Number of distinct medications dispensed in the final 12 months of life was computed from prescribing records. A binary logistic regression model was used to estimate the association between individual characteristics, the pandemic period, and death at home, and their average marginal effects (AME). ResultsDuring the pandemic, home decedents were on average 1.03 years older, more likely to be male and married, their Elixhauser Morbidity increased by 0.39, and they received 0.25 more medication types. The EI of home decedents increased past that of care home decedents. The adjusted effect of the pandemic on probability of death at home was AME = 5.9% (95%CI 5.5%,6.3%). ConclusionsIn addition to increasing by a third, home decedents were as ill as before the pandemic or more, and were somewhat more similar to hospital and care home decedents than before the pandemic. Policy support is needed for enabling care at home for complex needs and increased support for carers. |
|---|---|
| AbstractList | IntroductionDeaths at home increased by a third in Scotland during the pandemic period, yet little is known about the population who died at home. Policy towards supporting this increased number will benefit from understanding differences in the socio-demographic composition and clinical needs of those dying at home following the pandemic. ObjectivesTo describe the population who died at home in Scotland during the first year of the Covid-19 pandemic and compare them to the population of decedents five years prior, in terms of demographic and clinical characteristics and estimated palliative care needs. Demographic characteristics included age, sex assigned at birth, marital status, the area-based Scottish Index of Multiple Deprivation (SIMD) and the Scottish urban-rural indicator. MethodsRetrospective cohort study of death registrations for Scottish decedents between March 2015 and March 2021, with the 12-month period from 2020-03-23 defined as the pandemic period. Death registrations were linked to 10 years of inpatient admissions to identify comorbid conditions and compute the Elixhauser Comorbidity Index (EI). Palliative care needs were estimated from underlying and contributory causes of death using ICD-10 codes. Number of distinct medications dispensed in the final 12 months of life was computed from prescribing records. A binary logistic regression model was used to estimate the association between individual characteristics, the pandemic period, and death at home, and their average marginal effects (AME). ResultsDuring the pandemic, home decedents were on average 1.03 years older, more likely to be male and married, their Elixhauser Morbidity increased by 0.39, and they received 0.25 more medication types. The EI of home decedents increased past that of care home decedents. The adjusted effect of the pandemic on probability of death at home was AME = 5.9% (95%CI 5.5%,6.3%). ConclusionsIn addition to increasing by a third, home decedents were as ill as before the pandemic or more, and were somewhat more similar to hospital and care home decedents than before the pandemic. Policy support is needed for enabling care at home for complex needs and increased support for carers. Introduction Deaths at home increased by a third in Scotland during the pandemic period, yet little is known about the population who died at home. Policy towards supporting this increased number will benefit from understanding differences in the socio-demographic composition and clinical needs of those dying at home following the pandemic. Objectives To describe the population who died at home in Scotland during the first year of the Covid-19 pandemic and compare them to the population of decedents five years prior, in terms of demographic and clinical characteristics and estimated palliative care needs. Demographic characteristics included age, sex assigned at birth, marital status, the area-based Scottish Index of Multiple Deprivation (SIMD) and the Scottish urban-rural indicator. Methods Retrospective cohort study of death registrations for Scottish decedents between March 2015 and March 2021, with the 12-month period from 2020-03-23 defined as the pandemic period. Death registrations were linked to 10 years of inpatient admissions to identify comorbid conditions and compute the Elixhauser Comorbidity Index (EI). Palliative care needs were estimated from underlying and contributory causes of death using ICD-10 codes. Number of distinct medications dispensed in the final 12 months of life was computed from prescribing records. A binary logistic regression model was used to estimate the association between individual characteristics, the pandemic period, and death at home, and their average marginal effects (AME). Results During the pandemic, home decedents were on average 1.03 years older, more likely to be male and married, their Elixhauser Morbidity increased by 0.39, and they received 0.25 more medication types. The EI of home decedents increased past that of care home decedents. The adjusted effect of the pandemic on probability of death at home was AME = 5.9% (95%CI 5.5%,6.3%). Conclusions In addition to increasing by a third, home decedents were as ill as before the pandemic or more, and were somewhat more similar to hospital and care home decedents than before the pandemic. Policy support is needed for enabling care at home for complex needs and increased support for carers. |
| Author | Savinc, Jan Atherton, Iain |
| Author_xml | – sequence: 1 givenname: Jan orcidid: 0000-0002-0894-8571 surname: Savinc fullname: Savinc, Jan – sequence: 2 givenname: Iain orcidid: 0000-0002-1822-3240 surname: Atherton fullname: Atherton, Iain |
| BookMark | eNpNkU1rGzEQhkVIIWmaH5CbfkDW1dfKUm_FblpDIId-XMWsNGvL7K4WSTbk38dxQsll3mHm5bk8n8nllCYk5I6zhZDG2K9xP4eyOHIW-UJYIS_ItZDWNsoyc_lhvyK3pewZY4IrsdT8mhzXCHVXKFS6SyPScMhx2tLV07_NuuGWxon-9qkOMIVvdI1j2maYd9GXezoehhrHlLsYYn2-p6cKnWEYItR4ROohI50QQ3mFzGk-DKdHmmiACl_Ipx6GgrfveUP-Pvz4s_rVPD793Ky-PzZeSF0bj1q3WvCul6FTXPTG2i4ACtNbgLb10rd9bySToQ9omBHLZTAMAL0WpyFvyOaNGxLs3ZzjCPnZJYjufEh56yDX6Ad0HLX1QkumWqWs8kZJXHqlQXU-BKNPLP7G8jmVkrH_z-PMnT24swd39uBePcgXOGSAOg |
| ContentType | Journal Article |
| DBID | AAYXX CITATION DOA |
| DOI | 10.23889/ijpds.v10i1.2923 |
| DatabaseName | CrossRef DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef |
| DatabaseTitleList | CrossRef |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Economics |
| EISSN | 2399-4908 |
| ExternalDocumentID | oai_doaj_org_article_1e69c2630454494c843e7c46a4bcdd86 10_23889_ijpds_v10i1_2923 |
| GroupedDBID | AAFWJ AAYXX ADBBV AFPKN ALMA_UNASSIGNED_HOLDINGS BCNDV CITATION GROUPED_DOAJ M~E OK1 RPM |
| ID | FETCH-LOGICAL-c236t-ce665621bf3db412f899bdae28f9aa55c3c5ff8303dfde808277d80aaec62aec3 |
| IEDL.DBID | DOA |
| ISICitedReferencesCount | 0 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001607517100003&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 2399-4908 |
| IngestDate | Tue Oct 28 02:23:27 EDT 2025 Sat Oct 25 05:38:03 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 1 |
| Language | English |
| License | http://creativecommons.org/licenses/by/4.0 |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c236t-ce665621bf3db412f899bdae28f9aa55c3c5ff8303dfde808277d80aaec62aec3 |
| ORCID | 0000-0002-0894-8571 0000-0002-1822-3240 |
| OpenAccessLink | https://doaj.org/article/1e69c2630454494c843e7c46a4bcdd86 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_1e69c2630454494c843e7c46a4bcdd86 crossref_primary_10_23889_ijpds_v10i1_2923 |
| PublicationCentury | 2000 |
| PublicationDate | 2025-10-20 |
| PublicationDateYYYYMMDD | 2025-10-20 |
| PublicationDate_xml | – month: 10 year: 2025 text: 2025-10-20 day: 20 |
| PublicationDecade | 2020 |
| PublicationTitle | International journal of population data science |
| PublicationYear | 2025 |
| Publisher | Swansea University |
| Publisher_xml | – name: Swansea University |
| SSID | ssj0002142761 |
| Score | 2.307027 |
| Snippet | IntroductionDeaths at home increased by a third in Scotland during the pandemic period, yet little is known about the population who died at home. Policy... Introduction Deaths at home increased by a third in Scotland during the pandemic period, yet little is known about the population who died at home. Policy... |
| SourceID | doaj crossref |
| SourceType | Open Website Index Database |
| SubjectTerms | Administrative Data care at home end of life multimorbidity palliative care place of death |
| Title | Deaths at home during COVID-19 in Scotland: Demographics, multimorbidity, and palliative care needs in population data |
| URI | https://doaj.org/article/1e69c2630454494c843e7c46a4bcdd86 |
| Volume | 10 |
| WOSCitedRecordID | wos001607517100003&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 2399-4908 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0002142761 issn: 2399-4908 databaseCode: DOA dateStart: 20170101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 2399-4908 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0002142761 issn: 2399-4908 databaseCode: M~E dateStart: 20170101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV27TsMwFLUQQoIF8RTlJQ9MqKGN4zg2G_QhGCgMgLpFjh8iSE2jJnTk27l22qpMLCxWFDlWdBz5nBtfn4vQFbBCbKwWgVQhC2iYmYBHhgUgLrQ0WRyDVPLFJpLRiI_H4mWt1JfLCWvsgRvgOqFhQhHmNvQoFVRxGplEUSZpprTm3mwbVM9aMOXWYGckBgF6s40JrMRFJ_8sdXUzD7s5hIWCRL-IaM2v3xPLcA_tLhQhvmveZB9tmOIAbS8PDFeHaN53Mq3CssYf04nBzclC3Ht-f-wHocB5gV1ZepeieIv7ZtKYUMOjbezTBSfTWZZrUNttDF1wKd0fFrfKYZf2hQvgr8oNUq5qeWGXN3qE3oaD195DsCiXECgSsTpQhoE4I2FmI53RkFgIpTIAnHArpIxjFanYWg6cpa02HLg_STTvSmkUI9BEx2izmBbmBOFMhSaJhdCaMgohCIg8wYSJlJAWLm0LXS-xS8vGFSOFaMIDnXqgUw906oBuoXuH7qqjM7T2N2Ca08U0p39N8-l_DHKGdogr3wvUQ7rnaLOefZkLtKXmdV7NLv0XBO3T9-AHUE_Npw |
| linkProvider | Directory of Open Access Journals |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Deaths+at+home+during+COVID-19+in+Scotland%3A+Demographics%2C+multimorbidity%2C+and+palliative+care+needs+in+population+data&rft.jtitle=International+journal+of+population+data+science&rft.au=Savinc%2C+Jan&rft.au=Atherton%2C+Iain&rft.date=2025-10-20&rft.issn=2399-4908&rft.eissn=2399-4908&rft.volume=10&rft.issue=1&rft_id=info:doi/10.23889%2Fijpds.v10i1.2923&rft.externalDBID=n%2Fa&rft.externalDocID=10_23889_ijpds_v10i1_2923 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2399-4908&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2399-4908&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2399-4908&client=summon |