Place of Death

By June 16, 2020 Commentary

I have been meaning to spend a little time on place of death from coronavirus disease.  Not where a person lived, but where they died.  A death certificate has a line for both types of information.  I assumed that a large percent of those dying did so in a hospital.  The Centers for Disease Control has data both nationally and at a state level.  It lags the real time counts because CDC is dependent on states to provide the death certificates to it.  Looking at the current data on the website   (CDC Place of Death )   through June 10 it covered 95,608 deaths.  61,148 were in the hospital or 64%.  22,552 were in a nursing home or long-term care facility, or 23.6%.  4,816 were in the home, which I take to mean a private residence and 2031 were in a hospice with 3582 being in an outpatient or ER health care setting.

The Minnesota specific numbers are interesting.  996 deaths were included as of the data the CDC was reporting.  Only 322 deaths occurred in a hospital, or 32%.  594 were in a nursing home or long term care setting.  That is a whopping 60%.  None in a hospice.  52 at home.  80% of deaths are to residents of long-term care facilities.  So 75% of deaths of nursing home and other LTC residents are occurring in the nursing home or LTC setting.  One caveat is that a few deaths occurring in a skilled nursing facility could be people discharged from a hospital and doing further recovery in that setting, but that is unlikely to represent many of those deaths.  I have to believe that advance directives are a primary explanation.  A lot of people must have not wanted any intensive treatment.

Why is Minnesota so different from the national numbers?  Why do we have fewer people dying in a hospital and so many in an LTC facility?  We do have a higher rate of advance directives, but that seems unlikely to explain all of the difference.  Inquiring minds want to know.  I may poke around at data from some other states as well.

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