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- BLOG - Access to secure data during the Covid-19 pandemic - a model for the future?
- Covid-19 and Care Homes: Advances in Administrative Data Research during the pandemic
- DATA INSIGHTS -Deprivation and informal care at the end of life
- NEWS - Innovative new residential linkage tool launched
- BLOG SERIES - Dramatic increase in deaths at home- No.4
- DATA INSIGHTS - Youth Movements, Social Mobility and Health Inequalities
- NEWS - New report warns of deepening poverty crisis for Scottish families
- New report on Infants Born into Care in Scotland
- Spotlight on Dr Elizabeth Lemmon
- Spotlight on Jan Savinc
- BLOG - The value of social science and administrative data research in Scotland: how we are helping respond to COVID-19
- DATA INSIGHTS - Exploring illegal drug consignments in Scotland
- DATA INSIGHTS -Linking two administrative data sets about looked after children
- NEWS – ADR Scotland data ambassadors launched
- The importance of administrative data
- Virtual Conference - Data Linkage: Information to Impact
- BLOG SERIES - Dramatic increase in deaths at home - No.7
- BLOG SERIES - Dramatic increase in deaths at home
- BLOG SERIES - Dramatic increase in deaths at home- No.3
- DATA INSIGHTS - Investigating the effects of class composition and class size on pupils’ attainment in Scottish primary schools
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- DATA INSIGHTS - Automatic Coding of Occupations: Methods to create the Scottish Historic Population Database (SHPD)
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- EVENT - Active Travel: New Data, New Insights
- EVENT - Holyrood Evidence Week: Doing Data Better for Policy and Public Good
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- BLOG - Taking historical death records and developing a database for future analysis
- DATA INSIGHTS - Community mortality due to Covid-19
- Future-proofing investment into administrative data research announced in Scotland
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- Spotlight on Katherine Falconer
- ADR Scotland publishes its strategy for 2022-2026
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- DATA INSIGHTS - Homelessness duration in Scotland: how long does rehousing take?
- DATA INSIGHTS - Occupation and COVID-19 deaths: Scotland in a comparative perspective
- DATA INSIGHTS -The health and economic benefits of active commuting in Scotland
- IPDLN Conference - Data linkage research: informing policy and practice
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- ADR Scotland Winter Partnership Session - **internal event**
- BLOG - AGEING AND HOMELESSNESS IN SCOTLAND
- BLOG - Can we use linked administrative data to identify social disadvantage?
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- BLOG - The Dynamics of the Nursing Workforce in the UK: Using data to support our nurses
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- DATA INSIGHTS - Analysing a season of death and excess mortality in Scotland’s past
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- NEWS - Data research initiative secures £90 m funding extension
- NEWS: Our role supporting the new Covid-19 research data service in Scotland
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- Webinar - An Introduction to Looked-After Children Dataset
- BLOG - An Inside Job: Using Criminology, Police Data and a Lot of Nouse
- BLOG - Improving justice data to promote data justice in Scotland
- BLOG - Location of death in 2020: a changing trend from hospitals to homes
- BLOG - Seeking feedback on Research Data Scotland’s core principles via our public panel
- BLOG - What skills, training and support are required by those wishing a career as an administrative data researcher?
- BLOG No. 9 - Final blog in this 'deaths at home' series
- BLOG SERIES - Dramatic increase in deaths at home - No. 6
- BLOG SERIES - Dramatic increase in deaths at home - No.8
- BLOG SERIES - Dramatic increase in deaths at home- No.5
- BLOG: 5 things I've learnt about working with policymakers...
- BLOG: Automating Coding for Large Historical Datasets
- BLOG: COVID-19- How increased deaths at home impact the carer community
- DATA INSIGHTS -Postal deliveries of drugs in Scotland
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- NEWS: Police use of Fixed Penalty Notices under the Covid-19 regulations in Scotland: A new data report highlights links with deprivation and inequality
- NEWS: Police use of the new Covid-19 powers: Using administrative data to analyse and evaluate practice
- Research Data Scotland - New user forum
- Spotlight on Dr Patricio Troncoso
- Summary of ADR Scotland Winter Partnership session
- Directorship of the International Population Data Linkage Network (IPDLN) for 2021-22.
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BLOG - Location of death in 2020: a changing trend from hospitals to homes
This week, SCADR researcher, Dr David Henderson, discusses how the COVID-19 pandemic has changed the patterns in location of death and the various questions this raises.
From February 2020, Government bodies and Health Boards prepared for an influx of very unwell patients due to the effects of COVID-19, resulting in an unprecedented reconfiguration of hospital services at rapid speed. During this time, when the effect of lockdown measures was an unknown quantity, concerns were rightly raised that acute and critical care NHS services could be stretched beyond their capacity.
Reviewing figures reported by National Records of Scotland (NRS) in Scotland, has shown two striking differences occurring, when compared to the same time (weeks 11-20) in previous years:
- Emergency admissions to hospital had fallen below normal levels – particularly for non-COVID-19 conditions
- Subsequently, deaths in hospital not attributable to COVID-19 are much lower than average.
Whilst hospital services have understandably focussed on prioritising COVID-19 care, the question about ‘where’ these 'normal deaths' have occurred has arisen. Using the statistics on location of death, published by the NRS, we can illustrate location of death in the figure above.
We can see that in the first 10 weeks of 2020, deaths by location were, by and large, similar to the average in the preceding 5 years. The first death from COVID-19 in Scotland was recorded in week 12. For weeks 11-20 that deaths in hospitals not attributable to COVID-19 are markedly lower, whilst those in Care Homes and, particularly at home, or in non-institutional settings have increased.
It is important to note that the above figures do not include deaths due to COVID-19 which significantly affects the overall numbers of deaths in Hospital and Care Homes. The purpose of excluding them here, is to try and understand how the location of 'end-of-life' has shifted for "normal" deaths.
The increase at home and community settings raises numerous questions about how primary care, social care, and care home services have been affected by the reduction in hospital-based deaths – particularly where there was a need for palliative care.
Whilst aggregate statistics published by NRS are very useful for identifying crude trends, linking individual-level administrative data has the potential to offer stronger analyses. Currently we do not know how many care home residents have died in hospital due to COVID-19. Other questions to explore include:
- What services did those dying at home require in their last-days?
- Will the trend of dying at home persist beyond the pandemic, or will hospitals return to being the “normal” place of death?
- Will the barriers that were broken in securing rapid transfer out of hospital remain after the pandemic, or will the level of delayed discharges rise once again?
Further details - article on Scottish Care Homes and COVID-19 available here.
What next?
The questions above are just some of the questions that the Scottish Centre for Administrative Data Research (SCADR) researchers will aim to answer over the coming months and years, using administrative records to enhance our understanding of end of life patterns and care and the ways we might need to adapt or enhance our services and support in this area.
If you would like to discuss these findings, please tweet @_davidhen
This article was published on 03 Apr 2020