ArticleJournal of general internal medicine2024
Changes in Site of Death Among Older Adults Without a COVID-19 Diagnosis During the COVID-19 Pandemic.
Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Changes in Home-visit Care Utilization and Outcomes During the Coronavirus Disease 2019 Pandemic: Comparison Between Patients With and Without Cancer.Journal of epidemiology · 2026Observational
- Palliative care impact on hospital utilization and trends among lung cancer admissions with a high risk of mortality in U.S. hospitals.Frontiers in health services · 2026Article
- Perceptions of care quality and human rights in Italian outpatient facilities during and after the pandemic.Frontiers in public health · 2026Article
- Characteristics of cancer patients dying at home during the COVID-19 pandemic: A study based on vital statistics from 2015 to 2022 in Japan.Journal of general and family medicine · 2024Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundUnderstanding how the coronavirus disease 2019 (COVID-19) pandemic affected site of death-an important patient-centered outcome related to end-of-life care-would inform healthcare system resiliency in future public health emergencies.
objectiveTo evaluate the changes in site of death during the COVID-19 pandemic among older adults without a COVID-19 diagnosis.
designUsing a quasi-experimental difference-in-differences method, we estimated net changes in site of death during the pandemic period (March-December 2020) from the pre-pandemic period (January-February 2020), using data on the same months in prior years (2016-2019) as the control.
participantsA 20% sample of Medicare Fee-for-Service beneficiaries aged 66 years and older who died in 2016-2020. We excluded beneficiaries with a hospital diagnosis of COVID-19. MAIN MEASURES: We assessed each of the following sites of death separately: (1) home or community; (2) acute care hospital; and (3) nursing home. KEY
resultsWe included 1,133,273 beneficiaries without a hospital diagnosis of COVID-19. We found that the proportion of Medicare beneficiaries who died at home or in the community setting increased (difference-in-differences [DID] estimate, + 3.1 percentage points [pp]; 95% CI, + 2.6 to + 3.6 pp; P < 0.001) and the proportion of beneficiaries who died (without COVID-19 diagnosis) in an acute care hospital decreased (- 0.8 pp; 95% CI, - 1.2 to - 0.4 pp; P < 0.001) during the pandemic. We found no evidence that the proportion of deaths in nursing homes changed during the pandemic.
conclusionsUsing national data on older adults without a COVID-19 diagnosis, we found that site of death shifted toward home or community settings during the COVID-19 pandemic. Our findings may inform clinicians and policymakers in supporting end-of-life care during future public health emergencies.
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