Study on the rise of home deaths during the COVID-19 pandemic published on the eClinicalMedicine journal

Study on the rise of home deaths during the COVID-19 pandemic published on the eClinicalMedicine journal

The project that’s EU-funded – EOLinPLACE – is creating a solid base for the first international classification tool to map preferred and actual places towards death, giving word to people who wants to choose it’s preferences for a place to live it’s last days. This project is hosted by the Faculty of Medicine of the University of Coimbra, led by palliative care researcher, Bárbara Gomes, along with CHRC and ENSP-NOVA Senior Researcher, Sílvia Lopes.

This project objective is to contribute the improvement of the healthcare provision at the end of life, aiming to transform the way in which places people are cared for at the end of their lives and where they end up dying. The study included data on more than 100 million people who died over a decade in 32 countries, including Portugal. 

During the COVID-19 pandemic, a new study from this project was carried out - “The rise of home death in the COVID-19 pandemic: a population-based study of death certificate data for adults from 32 countries, 2012-2021” – that was recently published in the renowned eClinicalMedicine journal, edited by The Lancet. 

The COVID-19 pandemic, had a great influence in mortality patterns, likely including the trends of dying places. This published study shows the trend results 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).” This study presents new data that can contribute to defining health strategies and policies that improve the provision of health care at the end of life.

“Data from places of death from the first years of the pandemic (2020-21) were compared with data from the eight years prior to the pandemic (2012-19). In the set of countries analyzed, the percentage of deaths at home increased from 30.1% in 2012-13 to 30.9% in 2018-19; and even to 32.2% in the pandemic (2020-21). However, in Portugal, and in contrast to most other countries, the percentage of deaths at home decreased from 27.4% in 2012-13 to 24.9% in 2018-19; and even to 23.2% during the pandemic (2020-21).”

The data reveals that Portugal has been suffering a significant decrease in deaths at home, entering in a countercycle comparatively to most of the countries that have been analyzed. 

“We were already one of the countries with a more pronounced trend of hospital deaths in the years before the pandemic. The investment that has been made in home palliative care may not be enough to significantly reach everyone who needs it. With limited support at home, recourse to hospitals and other health institutions becomes almost inevitable”, explained Sílvia Lopes and Bárbara Gomes. 

“It’s urgent to reflect on the Portuguese situation in this international context, considering the importance of promoting real choices regarding the place where people with advanced disease prefer to live until the end” – added the leading researchers of the project. 

"EOLinPLACE - Choice of where we die: a classification reform to discern diversity in individual end of life pathways" was funded by the European Research Council (ERC) under the European Commission's Horizon 2020 Program.

Access to the published paper at https://doi.org/10.1016/j.eclinm.2023.102399

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Author

Andreia Santos

Researchers

Sílvia Lopes