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Changes in mortality patterns and place of death during the COVID-19 pandemic: A descriptive analysis of mortality data across four nations

O’Donnell, Sean B.; Bone, Anna E.; Finucane, Anne M.; McAleese, Jenny; Higginson, Irene J.; Barclay, Stephen; Sleeman, Katherine E.; Murtagh, Fliss E.M.


Sean B. O’Donnell

Anna E. Bone

Anne M. Finucane

Jenny McAleese

Irene J. Higginson

Stephen Barclay

Katherine E. Sleeman


Background: Understanding patterns of mortality and place of death during the COVID-19 pandemic is important to help provide appropriate services and resources. Aims: To analyse patterns of mortality including place of death in the United Kingdom (UK) (England, Wales, Scotland and Northern Ireland) during the COVID-19 pandemic to date. Design: Descriptive analysis of UK mortality data between March 2020 and March 2021. Weekly number of deaths was described by place of death, using the following definitions: (1) expected deaths: average expected deaths estimated using historical data (2015–19); (2) COVID-19 deaths: where COVID-19 is mentioned on the death certificate; (3) additional non-COVID-19 deaths: above expected but not attributed to COVID-19; (4) baseline deaths: up to and including expected deaths but excluding COVID-19 deaths. Results: During the analysis period, 798,643 deaths were registered in the UK, of which 147,282 were COVID-19 deaths and 17,672 were additional non-COVID-19 deaths. While numbers of people who died in care homes and hospitals increased above expected only during the pandemic waves, the numbers of people who died at home remained above expected both during and between the pandemic waves, with an overall increase of 41%. Conclusions: Where people died changed during the COVID-19 pandemic, with an increase in deaths at home during and between pandemic waves. This has implications for planning and organisation of palliative care and community services. The extent to which these changes will persist longer term remains unclear. Further research could investigate whether this is reflected in other countries with high COVID-19 mortality.


O’Donnell, S. B., Bone, A. E., Finucane, A. M., McAleese, J., Higginson, I. J., Barclay, S., …Murtagh, F. E. (2021). Changes in mortality patterns and place of death during the COVID-19 pandemic: A descriptive analysis of mortality data across four nations. Palliative medicine, 35(10), 1975-1984.

Journal Article Type Article
Acceptance Date Jul 31, 2021
Online Publication Date Aug 23, 2021
Publication Date Dec 1, 2021
Deposit Date Dec 3, 2021
Publicly Available Date Dec 7, 2021
Journal Palliative Medicine
Print ISSN 0269-2163
Electronic ISSN 1477-030X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 35
Issue 10
Pages 1975-1984
Keywords Palliative care; Terminal care; COVID-19; Pandemics; Mortality; Residential facilities; Place of death
Public URL


Published article (1.3 Mb)

Copyright Statement
© The Author(s) 2021. article is distributed under the terms of the Creative Commons Attribution 4.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (

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