Deaths at home during the Covid-19 pandemic in Scotland

This research builds on our earlier work, and explores the increase in deaths at home during the Covid pandemic and its implications for end of life care and health service usage.

Research Focus

The Covid-19 pandemic has seen a large increase in numbers of people dying at home. Deaths at home have increased by 36% relative to pre-pandemic levels. Only about 2% of those deaths were Covid related, with most deaths happening due to other causes.

Little is known about the characteristics of the population dying at home during this time. As present we don't know what precipitated the shift to home deaths or how home deaths today compare to those before the pandemic. Importantly, the sustained increase of home deaths throughout the pandemic period raises questions about the availability of services, ability to access both formal and unpaid care, and the quality of care received by individuals dying at home.

We will investigate the health needs and services used by people who died at home during the pandemic and how they differed from people dying in hospital or care homes, but also from people dying at home before the pandemic. This work is important given that insights into the causes and consequences of the shift to home deaths can facilitate end-of-life care policy in the post-pandemic world.

This work is a continuation of our Care in the Last Days of Life project.

Data sources

NRS Deaths records (used to define cohort and some demographics)
CHI registry data (use to identify medical records for cohort and some demographics)
UPRN (Universal property reference number; for identifying the number of household members living with individuals in cohort and for address changes in the last year of life)
SMR01 Acute hospital admissions
SMR04 Psychiatric admissions
SMR06 Cancer registrations
Unscheduled care datasets
NHS24 calls
SAS ambulance service use
Out-of-hours GP episodes
A&E admissions
Prescribing data (DVCP dispensed & prescribed)
Hospital proximity calculations (this will be computed at Data Zone level by ourselves)
Monthly hospital bed occupancy data (from aggregated ISD(S)1 hospital activity data)

Qualitative study

Alongside the quantitative study of the linked data above, we are also undertaking engagement in the form of interviews and focus groups with key people from charitable organisations involved in providing end-of-life care, as well as unpaid carers, about their experiences of providing care during the pandemic. Please read Blog 7 for a brief summary.

Research team

Jan Savinc, Iain Atherton, Yina García-López, Catherine Mahoney, Michelle Jamieson

From December 2021, we are also working on a new project Exploring the increase in deaths at home in Scotland, both during Covid-19 and after the pandemic.