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

Sep 17, 2026

Upload by Asher

The study investigates how the COVID-19 pandemic changed the place of death for adults across 32 countries. Using death certificate data from 2012–2021, it compares 2020–2021 with the eight pre-pandemic years (2012–2019). “Home” is identified as the most common destination, with a pandemic increase in home deaths observed in most countries. Results show variability by country, sex, age, and cause of death, including larger rises for women and cancer-related deaths.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages11

Reading Time4 min

AccessFree to download

Summary

Background

Methods

Findings

Interpretation

Funding

Research in context

Evidence before this study

Articles 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 Sílvia Lopes,a,b Andrea Bruno de Sousa,a Mayra Delalibera,a Elizabeth Namukwaya,a,c Joachim Cohen,d and Barbara Gomesa,e, ∗ aFaculty of Medicine, University of Coimbra, Coimbra, Portugal bNOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal cPalliative Care Unit, Department of Medicine, Makerere College of Health Sciences, Kampala, Uganda dEnd-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium eKing’s College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, United Kingdom Summary Background During the coronavirus 2019 disease (COVID-19) pandemic, health systems had to respond to the needs of COVID-19 patients, while caring for patients with other life-threatening conditions. Pandemics, such as the COVID-19 pandemic, stir global health and mortality patterns. This is likely to include trends in dying places. In this paper, we examine trends 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) . Methods Data on place of death for all adults (18 years and over) that died from 1 January 2012 to 31 December 2021 were requested (47 countries approached, 32 included) . The classiﬁcation of place of death varied widely between countries. “Home” was the most common category, the remaining category groups comprised “hospital or health institution”, “other deﬁned”, and “ill-deﬁned”. We analysed place of death data in an aggregate form, by sex, age group, and selected underlying causes of death (cancer, dementia, and COVID-19) . Findings The study included 100.7 million people (51.5% male, 68.0% with ≥70 years), 20.4% died from cancer and 5.8% from dementia; 30.8% of deaths took place at home. The percentage of home deaths rose from 30.1% in 2012–2013 to 30.9% in 2018–2019 and further to 32.2% in the pandemic (2020–2021). Home deaths increased during the pandemic in 23 countries. In most countries the rise was greater in women and cancer; age differences were not consistent. Interpretation Our study shows that there was a rise in home deaths during the pandemic, but with variability across countries, sex, age, and causes of death. The sex difference observed in most countries may have several explanations, including more engagement of women in discussions about end of life care planning and hospital admission avoidance. A higher rise of home deaths among people dying of cancer may be explained by the more predictable disease trajectory compared to non-malignant conditions, as well as earlier and better integrated palliative care. Funding This work is part of the EOLinPLACE Project, which has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 948609) . Copyright © 2023 The Author(s) . Published by Elsevier Ltd. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)). Keywords: Adult; COVID-19; Death certiﬁcates; Mortality; Palliative care Introduction During the coronavirus 2019 disease (COVID-19) pandemic, health systems had to respond to the needs of COVID-19 patients. They also had to continue caring for patients with other life-threatening conditions, some of whom died from these conditions while others died from COVID-19 due to their increased risk proﬁle. The global excess of all-cause mortality during the pandemic, *Corresponding author. Faculty of Medicine, University of Coimbra, Pólo III, Sub-Unidade 3, Azinhaga de Santa Comba, Coimbra 3000-548, Portugal. E-mail [address:](address: barbara.gomes@uc.

FAQs

What does the study examine regarding the COVID-19 pandemic?

It examines trends in the place of death for adults across 32 countries, comparing 2020–2021 with 2012–2019.

How is place of death categorized in the analysis?

Place of death is grouped into categories including “home,” “hospital or health institution,” “other deﬁned,” and “ill-deﬁned,” depending on how countries classify it.

What key finding is reported about deaths occurring at home?

The share of home deaths increased during the pandemic period (2020–2021) and rose in 23 countries, with differences by sex and cause of death.

Sep 17, 2026

Upload by Asher