The Percentage of Time in the Last Six Months of Life Spent at Home or in a Community Setting
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
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
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
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
Frequency of Data Collection in Days
Reporting Methods
Public reporting.
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
www.publichealthscotland.scot/media/22520/2023-10-10reportfinal.pdf; www.gov.scot/binaries/content/documents/govscot/publications/strategy-plan/2015/12/strategic-framework-action-palliative-end-life-care/documents/supporting-evidence-summary/supporting-evidence-summary/govscot%3Adocument/00491390.pdf www.palliativecarescotland.org.uk/content/publications/29.-Palliative-and-End-of-Life-Care-What-do-we-know-from-Hospital-Hospice-and-Community-data.pdf