The Percentage of Time in the Last Six Months of Life Spent at Home or in a Community Setting

Identifying Attributes

Care Settings
Palliative Care
Country
Scotland
Publishing Organisation
Public Health Scotland
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Care of the Patient at the End of Life

Defining Attributes

Definition

Percentage of time in the last six months of life that is spent outside of a hospital setting.

Numerator

National Records of Scotland death records are linked to hospital discharge data (based on Acute Inpatient and Day Case and Geriatric Long Stay (SMR01, SMR01 GLS) and Mental Health Inpatient and Day Case (SMR04) returns covering non-obstetric hospitals in Scotland) and the actual number of bed days spent in hospital in Scotland in the six months prior to the death of each individual is calculated and added together for all individuals. This includes bed days from all acute and community hospitals, psychiatric hospitals or geriatric long stay facilities. The percentage of time spent in hospital in the last six months of life is therefore arrived at by dividing the actual number of bed days by the possible number of bed days. The percentage of time spent at home or in a community setting is then obtained by subtracting the percentage of time spent in hospital from 100%.

Denominator

Scottish residents who died in the fiscal year are identified using date of death on National Records of Scotland death records. The possible number of bed days that could have been spent in hospital in a six-month period is calculated by multiplying the total number of deaths by 182.5.

Exclusions

Patients who died where an external cause of death (e.g. unintentional injuries) is recorded on the death record are excluded from the analysis however patients who died where a fall is recorded are included. Patients with missing postcodes are excluded.

Use of Risk Adjustment
No
Risk Adjustments
Stratifications

Figures are presented at NHS Board and Health and Social Care Partnership levels with further demographic breakdowns on sex, age, deprivation and rurality.

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Scottish residents who died are identified using date of death on National Records of Scotland death records. The deaths data are linked to hospital discharge data (based on Acute Inpatient and Day Case and Geriatric Long Stay (SMR01, SMR01 GLS) and Mental Health Inpatient and Day Case (SMR04) returns covering non-obstetric hospitals in Scotland). This includes bed days from all acute and community hospitals, psychiatric hospitals or geriatric long stay facilities.

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods

Public reporting.

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025