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      Have increased deaths at home during the pandemic returned to pre-pandemic levels? An analysis of publicly available Scottish death registrations

      brief-report
      ,
      Journal of Public Health (Oxford, England)
      Oxford University Press
      mortality, older people, places

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          Abstract

          Background

          Deaths at home increased in Scotland at the start of the Coronavirus disease 2019 (COVID-19) pandemic by ~35%. The majority did not involve COVID-19. This has implications for resource allocation and care at the end of life.

          Methods

          Publicly available weekly death registrations by National Records Scotland (NRS) between 2015 and week 25 of 2023 were summarized by place of death. Linear and logistic regressions of the number and proportion of deaths at home, respectively, between 2015 and 2019, were used to estimate the expected number and proportion of deaths in the period 2020–2023 had the pandemic not happened.

          Results and conclusion

          The number of deaths at home continues in 2023 at rates similar to the pandemic period and has not reverted to pre-pandemic levels. Had the pre-pandemic trend of growth in deaths at home continued, the number of deaths observed in 2020 would not be observed until 2025–2032. Deaths at home increased across Local Authorities but the scale of the increase varied. The impact of the increased number of deaths at home on quality of care and quality of death is not known and requires further study.

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          Most cited references9

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          How many people need palliative care? A study developing and comparing methods for population-based estimates.

          Understanding the need for palliative care is essential in planning services.
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            Health care expenditures, age, proximity to death and morbidity: Implications for an ageing population

            This paper uses Hospital Episode Statistics, English administrative data, to investigate the growth in admitted patient health care expenditures and the implications of an ageing population. We use two samples of around 40,000 individuals who (a) used inpatient health care in the financial year 2005/06 and died by the end of 2011/12 and (b) died in 2011/12 and had some hospital utilisation since 2005/06. We use a panel structure to follow individuals over seven years of this administrative data, containing estimates of inpatient health care expenditures (HCE), information regarding individuals' age, time-to-death (TTD), morbidities at the time of an admission, as well as the hospital provider, year and season of admission. We show that HCE is principally determined by proximity to death rather than age, and that proximity to death is itself a proxy for morbidity.
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              Global impact of COVID-19 pandemic on road traffic collisions

              Background Various strategies to reduce the spread of COVID-19 including lockdown and stay-at-home order are expected to reduce road traffic characteristics and consequently road traffic collisions (RTCs). We aimed to review the effects of the COVID-19 pandemic on the incidence, patterns, and severity of the injury, management, and outcomes of RTCs and give recommendations on improving road safety during this pandemic. Methods We conducted a narrative review on the effects of COVID-19 pandemic on RTCs published in English language using PubMed, Scopus, and Google Scholar with no date restriction. Google search engine and websites were also used to retrieve relevant published literature, including discussion papers, reports, and media news. Papers were critically read and data were summarized and combined. Results Traffic volume dropped sharply during the COVID-19 pandemic which was associated with significant drop in RTCs globally and a reduction of road deaths in 32 out of 36 countries in April 2020 compared with April 2019, with a decrease of 50% or more in 12 countries, 25 to 49% in 14 countries, and by less than 25% in six countries. Similarly, there was a decrease in annual road death in 33 out of 42 countries in 2020 compared with 2019, with a reduction of 25% or more in 5 countries, 15–24% in 13 countries, and by less than 15% in 15 countries. In contrast, the opposite occurred in four and nine countries during the periods, respectively. There was also a drop in the number of admitted patients in trauma centers related to RTCs during both periods. This has been attributed to an increase in speeding, emptier traffic lanes, reduced law enforcement, not wearing seat belts, and alcohol and drug abuse. Conclusions The COVID-19 pandemic has generally reduced the overall absolute numbers of RTCs, and their deaths and injuries despite the relative increase of severity of injury and death. The most important factors that affected the RTCs are decreased mobility with empty lines, reduced crowding, and increased speeding. Our findings serve as a baseline for injury prevention in the current and future pandemics.
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                Author and article information

                Contributors
                Journal
                J Public Health (Oxf)
                J Public Health (Oxf)
                pubmed
                Journal of Public Health (Oxford, England)
                Oxford University Press
                1741-3842
                1741-3850
                December 2023
                18 August 2023
                18 August 2023
                : 45
                : 4
                : e664-e667
                Affiliations
                Edinburgh Napier University, School of Health & Social Care , Edinburgh EH11 4BN, UK
                Scottish Centre for Administrative Data Research , Edinburgh EH8 9BT, UK
                Edinburgh Napier University, School of Health & Social Care , Edinburgh EH11 4BN, UK
                Scottish Centre for Administrative Data Research , Edinburgh EH8 9BT, UK
                Author notes
                Address correspondence to Savinc J, E-mail: j.savinc@ 123456napier.ac.uk
                Author information
                https://orcid.org/0000-0002-0894-8571
                Article
                fdad156
                10.1093/pubmed/fdad156
                10687594
                37596241
                6e04eec3-3180-4e32-b663-5e7452f5ae18
                © The Author(s) 2023. Published by Oxford University Press on behalf of Faculty of Public Health.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 April 2023
                : 6 July 2023
                : 25 July 2023
                Page count
                Pages: 4
                Funding
                Funded by: Economic and Social Research Council, DOI 10.13039/501100000269;
                Award ID: ES/S007407/1
                Categories
                Editor's Choice
                Short Report
                AcademicSubjects/MED00860

                Public health
                mortality,older people,places
                Public health
                mortality, older people, places

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