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What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death

Bone, Anna E; Gomes, Barbara; Etkind, Simon N; Verne, Julia; Murtagh, Fliss EM; Evans, Catherine J; Higginson, Irene J


Anna E Bone

Barbara Gomes

Simon N Etkind

Julia Verne

Catherine J Evans

Irene J Higginson



© 2017, © The Author(s) 2017. Background: Population ageing represents a global challenge for future end-of-life care. Given new trends in place of death, it is vital to examine where the rising number of deaths will occur in future years and implications for health and social care. Aim: To project where people will die from 2015 to 2040 across all care settings in England and Wales. Design: Population-based trend analysis and projections using simple linear modelling. Age- and gender-specific proportions of deaths in hospital, care home, home, hospice and ‘other’ were applied to numbers of expected future deaths. Setting/population: All deaths (2004–2014) from death registration data and predicted deaths (2015–2040) from official population forecasts in England and Wales. Results: Annual deaths are projected to increase from 501,424 in 2014 (38.8% aged 85 years and over) to 635,814 in 2040 (53.6% aged 85 years and over). Between 2004 and 2014, proportions of home and care home deaths increased (18.3%–22.9% and 16.7%– 21.2%) while hospital deaths declined (57.9%–48.1%). If current trends continue, numbers of deaths in care homes and homes will increase by 108.1% and 88.6%, with care home the most common place of death by 2040. If care home capacity does not expand and additional deaths occur in hospital, hospital deaths will start rising by 2023. Conclusion: To sustain current trends, end-of-life care provision in care homes and the community needs to double by 2040. An infrastructure across care settings that supports rising annual deaths is urgently needed; otherwise, hospital deaths will increase.


Bone, A. E., Gomes, B., Etkind, S. N., Verne, J., Murtagh, F. E., Evans, C. J., & Higginson, I. J. (2018). What is the impact of population ageing on the future provision of end-of-life care? Population-based projections of place of death. Palliative medicine, 32(2), 329-336.

Journal Article Type Article
Acceptance Date Sep 8, 2017
Online Publication Date Oct 10, 2017
Publication Date Feb 1, 2018
Deposit Date Apr 29, 2018
Publicly Available Date May 2, 2018
Journal Palliative Medicine
Print ISSN 0269-2163
Electronic ISSN 1477-030X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 32
Issue 2
Pages 329-336
Keywords Anesthesiology and Pain Medicine; General Medicine
Public URL
Publisher URL


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