Out-of-Hospital Covid-19 Deaths

Consequences for Quality of Medical Care and Accuracy of Cause of Death Coding

Bibliographic Data

ID11034653
AuthorsElizabeth B Pathak (0000-0002-9702-0782, Elizabeth B. Pathak, Rebecca B. Garcia, and Janelle M. Menard are with the Women’s Institute for Independent Social Enquiry, Olney, MD. Jason L. Salemi is with the College of Public Health, University of South Florida, Tampa.), Rebecca B Garcia (0000-0003-4912-0479, Elizabeth B. Pathak, Rebecca B. Garcia, and Janelle M. Menard are with the Women’s Institute for Independent Social Enquiry, Olney, MD. Jason L. Salemi is with the College of Public Health, University of South Florida, Tampa.), Janelle M Menard (Elizabeth B. Pathak, Rebecca B. Garcia, and Janelle M. Menard are with the Women’s Institute for Independent Social Enquiry, Olney, MD. Jason L. Salemi is with the College of Public Health, University of South Florida, Tampa.), Jason L Salemi (0000-0002-0077-6023, Elizabeth B. Pathak, Rebecca B. Garcia, and Janelle M. Menard are with the Women’s Institute for Independent Social Enquiry, Olney, MD. Jason L. Salemi is with the College of Public Health, University of South Florida, Tampa.)
Year2021
Volume111
IssueS2
PagesS101-S106
Publication date2021-07-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2021.306428
LanguageEN
Citations received6
References cited12

Objectives. To examine age and temporal trends in the proportion of COVID-19 deaths occurring out of hospital or in the emergency department and the proportion of all noninjury deaths assigned ill-defined causes in 2020. Methods. We analyzed newly released (March 2021) provisional COVID-19 death tabulations for the entire United States. Results. Children (younger than 18 years) were most likely (30.5%) and elders aged 64 to 74 years were least likely (10.4%) to die out of hospital or in the emergency department. In parallel, among all noninjury deaths, younger people had the highest proportions coded to symptoms, signs, and ill-defined conditions, and percentage symptoms, signs, and ill-defined conditions increased from 2019 to 2020 in all age–race/ethnicity groups. The majority of young COVID-19 decedents were racial/ethnic minorities. Conclusions. The high proportions of all noninjury deaths among children, adolescents, and young adults that were coded to ill-defined causes in 2020 suggest that some COVID-19 deaths were missed because of systemic failures in timely access to medical care for vulnerable young people. Public Health Implications. Increasing both availability of and access to the best hospital care for young people severely ill with COVID-19 will save lives and improve case fatality rates

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