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Death at Home or in Community

​​This indicator provides the percentage of Canadians who die at home or in the community each year.

A higher percentage is desirable.

Data updated:
Data availability: to (calendar years)
Geographic coverage
All provinces/territories
Reporting level
National, Province/Territory
Calculation

The percentage of people who die outside the hospital each year
The numerator is the total number of deaths at home or in the community. This is calculated based on the difference between the total number of deaths in Canada and the total number of deaths in emergency departments and acute care hospitals. The denominator is the total number of deaths in Canada. 

(All deaths in Canada [CVSD and Yukon death data] – Deaths in acute care hospitals and EDs [DAD/HMDB, OHMRS, NACRS]) ÷ All deaths in Canada (CVSD and Yukon death data)

Notes
CVSD: Canadian Vital Statistics Death Database.
ED: Emergency department.
DAD/HMDB: Discharge Abstract Database/Hospital Morbidity Database 
OMHRS: Ontario Mental Health Reporting System.
NACRS: National Ambulatory Care Reporting System.

Denominator

All deaths that occur in the calendar year (captured in CVSD and Yukon death data)

Numerator

All deaths in the community in Canada in a calendar year

•    Calculated by subtracting hospital and ED deaths from all deaths (CVSD/Yukon)

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Name

Death at Home or in Community

Short/Other Names

Percentage of People Who Die Outside of Hospitals Each Year

Description

Percentage of Canadians who die at home or in the community each year
“Home or community” is broadly defined as a location that a person resides in at the end of life, excluding hospitals and other acute care facilities. Locations include

  • Long-term care facilities
  • Hospices 
  • Nursing homes 
  • Residential homes 
  • Assisted-living facilities
  • Group care homes 

This definition is intended to include the many types of living situations that may be considered “home” at the end of life.
 

Rationale

Measuring the percentage of Canadians who die at home or in the community, rather than in hospital, provides an indication of whether Canadians are getting access to community-based end-of-life care services. 

Many Canadians would prefer to receive end-of-life care at home rather than in hospital. One of the main barriers to dying at home is lack of support in the home. If more services in the home were available, more people could potentially be supported in dying at home. This indicator can monitor progress being made toward improving access to community-based end-of-life care services.
 

Interpretation

A higher percentage is desirable.

HSP Framework Dimension

Health system outputs: Access to comprehensive, high-quality health services

Areas of Need

End of Life

Targets/Benchmarks

N/A

Available Data Years

to (calendar years)

Geographic Coverage

  • All provinces/territories

Reporting Level/Disaggregation

  • National
  • Province/Territory

Indicator Results

Web Tool:
Your Health System: In Brief - Death at Home or in Community

Update Frequency

Every year

Latest Results Update Date

Updates

N/A

Description

The percentage of people who die outside the hospital each year
The numerator is the total number of deaths at home or in the community. This is calculated based on the difference between the total number of deaths in Canada and the total number of deaths in emergency departments and acute care hospitals. The denominator is the total number of deaths in Canada. 

(All deaths in Canada [CVSD and Yukon death data] – Deaths in acute care hospitals and EDs [DAD/HMDB, OHMRS, NACRS]) ÷ All deaths in Canada (CVSD and Yukon death data)

Notes
CVSD: Canadian Vital Statistics Death Database.
ED: Emergency department.
DAD/HMDB: Discharge Abstract Database/Hospital Morbidity Database 
OMHRS: Ontario Mental Health Reporting System.
NACRS: National Ambulatory Care Reporting System.

Type of Measurement

Percentage or proportion

Denominator

Description:

All deaths that occur in the calendar year (captured in CVSD and Yukon death data)

Inclusions:

All deaths in Canada in a calendar year: 

  • CVSD data 
  • Yukon death data
     

Exclusions:

  • CVSD: Deaths from external causes: 
    • Land transport accidents (V01–V89)
    • Assaults (X85–Y09, Y87.1)
    • Self-harm (X60–X84, Y87.0) 
    • Poisonings (X40–X49, X60–X69, Y10–Y19)
  • Yukon: Category codes for assaults and self-harm

Numerator

Description:

All deaths in the community in Canada in a calendar year

•    Calculated by subtracting hospital and ED deaths from all deaths (CVSD/Yukon)

Inclusions:

  • Deaths captured in acute and psychiatric hospitals (DAD/HMDB/OMHRS) 
  • All deaths captured in NACRS, CVSD data and Yukon death data 
  • Emergency department records (Amcare_Group_Code = ED)
  • Sex coded as male or female (Sex = M, F)
  • Records with valid age 
     

Exclusions:

  • Deaths from external causes:
    • Land transport accidents  (V01–V89)
    • Assaults (X85–Y09, Y87.1) 
    • Self-harm (X60–X84, Y87.0)
    • Suicide in facility (visit disposition = 74 in NACRS; discharge reason code = 2 in OMHRS)
    • Poisonings (X40–X49, X60–X69, Y10–Y19)
    • Dead on arrival (visit disposition = 71 in NACRS)
    • Stillbirths and cadaveric donors

Method of Adjustment

Direct standardization

Adjustment Applied

Age-adjusted

Geographic Assignment

Place of residence

Data Sources

  • DAD/HMDB
  • NACRS
  • OMHRS
  • Vital Statistics - Death Database, Statistics Canada
  • Vital Statistics Death Database, Yukon Government 

Caveats and Limitations

Results are based on all available data reported to CIHI; data coverage differs across jurisdictions. Therefore, results should not be compared.

Some hospitals may have palliative care units that provide care similar to that offered community hospices, but these cannot be differentiated in the data. This may result in a higher number of in-hospital deaths for jurisdictions that have more dedicated inpatient palliative care.

Certain patients may prefer hospital-based care at the end of life. As well, in some regions (e.g., rural and remote areas of Canada), acute care hospitals may be the only care setting in which patients can access palliative or end-of-life care services.

Yukon Vital Statistics data is not currently submitted to the CVSD; therefore, categories in the Yukon Vital Statistics may be associated with errors. Additionally, death data may be incomplete. This indicator should be interpreted with caution for the Yukon.

Due to coding practices of capturing deaths occurring in the community in Quebec emergency department data systems, we strongly suggest that information on deaths be used with caution.

Trending Issues

N/A

Comments

Pooled death data from 2017 to 2019 is used to age-standardize results.

This indicator belongs to the Shared Health Priorities portfolio measuring access to mental health and substance use services and to home and community care. 

More information on this indicator is available in the 2022 companion report (PDF). 
 

References

Canadian Institute for Health Information. Access to Palliative Care in Canada. 2018.

How to cite:

Canadian Institute for Health Information. Death at Home or in Community . Accessed April 25, 2025.