Hospital Beds Research Articles

Scheduling of elective operations with coordinated utilization of hospital beds and operating rooms

Scheduling of elective operations with coordinated utilization of hospital beds and operating rooms

Gamma Radiation-Mediated Synthesis of Antimicrobial Polyurethane Foam/Silver Nanoparticles

Nosocomial infections represent a major threat within healthcare systems worldwide, underscoring the critical need for materials with antimicrobial properties. This study presents the development of polyurethane foam embedded with silver nanoparticles (PUF/AgNPs) using a rapid, eco-friendly, in situ radiochemical synthesis method. The nanocomposites were characterized by UV–vis and FTIR spectroscopy, scanning electron microscopy coupled with energy dispersive X-ray technique (SEM/EDX), differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), tensile and compression strengths, antimicrobial activity, and foam toxicity tests. The resulting PUF/AgNPs demonstrated prolonged stability (over 12 months) and good dispersion of AgNPs. Also, the samples presented higher levels of hardness compared to samples without AgNPs (deformation of 1682 µm for V1 vs. 4307 µm for V0, under a 5 N force), tensile and compression strength of 1.80 MPa and 0.34 Mpa, respectively. Importantly, they exhibited potent antimicrobial activity against a broad range of bacteria (including Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, and Enterococcus faecalis) and a fungal mixture (no fungal growth on the sample surface was observed after 28 days of exposure). Furthermore, these materials were non-toxic to human keratinocytes, which kept their specific morphology after 24 h of incubation, highlighting their potential for safe use in biomedical applications. We envision promising applications for PUF/AgNPs in hospital bed mattresses and antimicrobial mats, offering a practical strategy to reduce nosocomial infections and enhance patient safety within healthcare facilities.

ANALYSIS OF THE STATE OF PSYCHIATRIC CARE IN UKRAINE

The aim of the study. To analyze the current state of psychiatric care in Ukraine against the background of its reform; to investigate the dynamics of individual indicators of mental health and the activity of institutions providing psychiatric care for the period 2008-2021. Material and methods. The materials of the study were official statistical data from the reports of the State Statistics Service of Ukraine, the Center for Medical Statistics of the Central Health Service of the Ministry of Health of Ukraine for 2008–2021, and the Institute of Health Indicators and Evaluation (IHME, USA) on the global burden of diseases. Bibliographic, epidemiological, medical-statistical, analytical methods were used in the research. The results. The relevance of studying the current state of the organization of psychiatric care in Ukraine is primarily determined by the growing need of the population in connection with the negative impact of the consequences of the war on mental health. It was established that the prevalence of mental disorders in Ukraine in the period from 2008 to 2017 decreased by 17.8% and amounted to 3944.8; primary morbidity decreased by 38.7% and amounted to 300.9 cases per 100,000 population in 2017. Mortality from mental disorders in the period 2008-2017 decreased by 2.7 times to 2.3 cases per 100,000 population. However, in 2021 it was already 2.4. According to the second stage of the health care reform, there is a reduction in inpatient psychiatric facilities and their bed fund (by 40-50% on average). Medical facilities that provide psychiatric care lack qualified specialists (53-73% of positions are filled). Conclusions. Deinstitutionalization, which is carried out in Ukraine, is consistent with the Concept of the state target program of mental health care in Ukraine for the period until 2030. When reducing beds in psychoneurological hospitals, it is necessary to create conditions for alternative treatment of mentally ill patients in order to maintain the availability of care. The dynamics of changes in mental health indicators and the activity of healthcare institutions have regional features that must be taken into account when calculating the need for various types of psychiatric care. Optimizing psychiatric care is hindered by a lack of psychiatrists and psychologists, but the involvement of family doctors in the provision of psychological care and the introduction of mobile interdisciplinary teams will help.

A multi-stage optimization model for managing epidemic outbreaks and hospital bed planning in Intensive Care Units

Intensive Care Unit (ICU) capacity can be significantly affected by disease outbreaks, epidemics, and pandemics, impeding the operational efficiency of healthcare systems and compromising patient care. This paper presents a multi-stage optimization approach to planning the location and distribution of ICU beds to increase accessibility and reduce mortality caused by a shortage of beds in a geographic region during epidemic events. Using a Brazilian state monthly hospital admissions due to Covid-19 from October 2020 to April 2021, we show the amount and the allocation of extra ICU beds that could reduce mortality, minimize patient travel and transportation, and increase accessibility while considering budget limitations. Our findings show coverage for 21 previously underserved municipalities, providing extra ICU beds for 69 municipalities, ranging from 880 to 1670 beds across seven months. On average, patients are displaced 56% less and access ICUs within 17 ± 2.3 kilometres (CI 95%). The strategy contributes to public health planning and the equitable allocation of hospital resources among the population.

Longitudinal trajectories of a claims-based frailty measure during adjuvant chemotherapy in women with stage I-III breast cancer.

Frailty is a dynamic syndrome characterized by reduced physiological reserve to maintain homeostasis. Prospective studies have reported frailty worsening in women with breast cancer during chemotherapy, with improvements following treatment. We evaluated whether the Faurot frailty index, a validated claims-based frailty measure, could identify changes in frailty during chemotherapy treatment and identified predictors of trajectory patterns. We included women (65+ years) with stage I-III breast cancer undergoing adjuvant chemotherapy in the SEER-Medicare database (2003-2019). We estimated the Faurot frailty index (range: 0-1; higher scores indicate greater frailty) at chemotherapy initiation, 4 months postinitiation, and 10 months postinitiation. Changes in frailty were compared to a matched noncancer comparator cohort. We identified patterns of frailty trajectories during the year following chemotherapy initiation using K-means clustering. Twenty-one thousand five hundred and ninety-nine women initiated adjuvant chemotherapy. Mean claims-based frailty increased from 0.037 at initiation to 0.055 4 months postchemotherapy initiation and fell to 0.049 10 months postinitiation. Noncancer comparators experienced a small increase in claims-based frailty over time (0.055-0.062). We identified 6 trajectory patterns: a robust group (78%), 2 resilient groups (16%), and 3 nonresilient groups (6%). Black women and women with claims for home hospital beds, wheelchairs, and Parkinson's disease were more likely to experience nonresilient trajectories. We observed changes in a claims-based frailty index during chemotherapy that are consistent with prior studies using clinical measures of frailty and identified predictors of nonresilient frailty trajectories. Our study demonstrates the feasibility of using claims-based frailty indices to assess changes in frailty during cancer treatment.

The effect of Certificate‐of‐Need laws on substance use disorder care for vulnerable populations

AbstractSubstance use disorders are a prevalent and growing problem across the United States, especially for households that rely on publicly funded healthcare insurance plans. State Certificate‐of‐Need (CON) laws for substance use disorder (SUD) treatment facilities can worsen outcomes for these patients by restricting the supply of facilities and beds, leading to spillovers into the general hospital system. We present a choice theory for treatment facility patient admission and model the outcome as a function of the patient's insurance type. We then combine two datasets on state CON laws for SUD treatment facilities with Medicaid patient data from 2017 to 2020 to test the model using a three‐stage least squares design and provide some of the first evidence on Medicaid patient outcomes under CON laws for SUD treatment facilities. We find significant evidence that state CON laws for SUD treatment facilities are associated with higher rates of hospital bed utilization, increases in the number of infants born with Neonatal Abstinence Syndrome, and higher rates of emergency department visits. Our findings are robust to several specification tests, including a model of conditional mixed method endogeneity and incorporating timing of the Affordable Care Act.

Managing "socially admitted" patients in hospital: a qualitative study of health care providers' perceptions.

Emergency departments are a last resort for some socially vulnerable patients without an acute medical illness (colloquially known as "socially admitted" patients), resulting in their occupation of hospital beds typically designated for patients requiring acute medical care. In this study, we aimed to explore the perceptions of health care providers regarding patients admitted as "social admissions." This qualitative study was informed by grounded theory and involved semistructured interviews at a Nova Scotia tertiary care centre. From October 2022 to July 2023, we interviewed eligible participants, including any health care clinician or administrator who worked directly with "socially admitted" patients. Virtual or in-person individual interviews were audio-recorded and transcribed, then independently and iteratively coded. We mapped themes on the 5 domains of the Quintuple Aim conceptual framework. We interviewed 20 nurses, physicians, administrators, and social workers. Most identified as female (n = 11) and White (n = 13), and were in their mid to late career (n = 13). We categorized 9 themes into 5 domains: patient experience (patient description, provision of care); care team well-being (moral distress, hierarchy of care); health equity (stigma and missed opportunities, prejudices); cost of care (wait-lists and scarcity of alternatives); and population health (factors leading to vulnerability, system changes). Participants described experiences caring for "socially admitted" patients, perceptions and assumptions underlying "social" presentations, system barriers to care delivery, and suggestions of potential solutions. Health care providers viewed "socially admitted" patients as needing enhanced care but identified individual, institutional, and system challenges that impeded its realization. Examining perceptions of the people who care for "socially admitted" patients offers insights to guide clinicians and policy-makers in caring for socially vulnerable patients.

A Geospatial Analysis of the Availability, Distribution, and Accessibility of Neurosurgical Facilities, Workforce, and Infrastructure in Nigeria; and Projection Towards 2050

There has been a modest but progressive increase in the neurosurgical workforce, training, and service delivery in Nigeria in the last 2decades. However, these resources are unevenly distributed. This study aimed to quantitatively assess the availability and distribution of neurosurgical resources in Nigeria while projecting the needed workforce capacity up to2050. An online survey of Nigerian neurosurgeons and residents assessed the country's neurosurgical infrastructure, workforce, and resources. The results were analyzed descriptively, and geospatial analysis was used to map their distribution. A projection model was fitted to predict workforce targets for 2022-2050. Out of 86 neurosurgery-capable health facilities, 65.1% were public hospitals, with only 17.4% accredited for residency training. Dedicated hospital beds and operating rooms for neurosurgery make up only 4.0% and 15.4% of the total, respectively. The population disease burden is estimated at 50.2 per 100,000, while the operative coverage was 153.2 cases per neurosurgeon. There are currently 132 neurosurgeons and 114 neurosurgery residents for a population of 218 million (ratio 1:1.65 million). There is an annual growth rate of 8.3%, resulting in a projected deficit of 1113 neurosurgeons by 2030 and 1104 by 2050. Timely access to neurosurgical care ranges from 21.6% to 86.7% of the population within different timeframes. Collaborative interventions are needed to address gaps in Nigeria's neurosurgical capacity. Investments in training, infrastructure, and funding are necessary for sustainable development and optimized outcomes.

Exploring COVID-19 census burdens by US hospital characteristics: Implications of quality reporting at rural and critical access hospitals.

By assessing longitudinal associations between COVID-19 census burdens and hospital characteristics, such as bed size and critical access status, we can explore whether pandemic-era hospital quality benchmarking requires risk-adjustment or stratification for hospital-level characteristics. We used hospital-level data from the US Department of Health and Human Services including weekly total hospital and COVID-19 censuses from August 2020 to August 2023 and the 2021 American Hospital Association survey. We calculated weekly percentages of total adult hospital beds containing COVID-19 patients. We then calculated the number of weeks each hospital spent at Extreme (≥20% of beds occupied by COVID-19 patients), High (10%-19%), Moderate (5%-9%), and Low (<5%) COVID-19 stress. We assessed longitudinal hospital-level COVID-19 stress, stratified by 15 hospital characteristics including joint commission accreditation, bed size, teaching status, critical access hospital status, and core-based statistical area (CBSA) rurality. Among n = 2582 US hospitals, the median(IQR) weekly percentage of hospital capacity occupied by COVID-19 patients was 6.7%(3.6%-13.0%). 80,268/213,383 (38%) hospital-weeks experienced Low COVID-19 census stress, 28% Moderate stress, 22% High stress, and 12% Extreme stress. COVID-19 census burdens were similar across most hospital characteristics, but were significantly greater for critical access hospitals. US hospitals experienced similar COVID-19 census burdens across multiple institutional characteristics. Evidence-based inclusion of pandemic-era outcomes in hospital quality reporting may not require significant hospital-level risk-adjustment or stratification, with the exception of rural or critical access hospitals, which experienced differentially greater COVID-19 census burdens and may merit hospital-level risk-adjustment considerations.

Diagnosing an overcrowded emergency department from its Electronic Health Records

Emergency department overcrowding is a complex problem that persists globally. Data of visits constitute an opportunity to understand its dynamics. However, the gap between the collected information and the real-life clinical processes, and the lack of a whole-system perspective, still constitute a relevant limitation. An analytical pipeline was developed to analyse one-year of production data following the patients that came from the ED (n = 49,938) at Uppsala University Hospital (Uppsala, Sweden) by involving clinical experts in all the steps of the analysis. The key internal issues to the ED were the high volume of generic or non-specific diagnoses from non-urgent visits, and the delayed decision regarding hospital admission caused by several imaging assessments and lack of hospital beds. Furthermore, the external pressure of high frequent re-visits of geriatric, psychiatric, and patients with unspecified diagnoses dramatically contributed to the overcrowding. Our work demonstrates that through analysis of production data of the ED patient flow and participation of clinical experts in the pipeline, it was possible to identify systemic issues and directions for solutions. A critical factor was to take a whole systems perspective, as it opened the scope to the boundary effects of inflow and outflow in the whole healthcare system.

An analysis of order utilization and overall costs secondary to an extended length of stay in hospitalized patients pending discharge to long term care facilities during the peak of Omicron

During the covid pandemic there was an influx of patients admitted to hospitals worldwide. This resulted in a presumptive overuse of resources, increased utilization costs, and decrease in hospital bed availability. This study focuses on patients admitted with a positive covid test, who required transfer to a long-term health facility after the acuity of their symptoms no longer required hospitalization but necessitated an extended length of stay due to acceptance into these facilities. Such facilities included: alternative living facility, skilled nursing facility, psychiatric institutions, or hospice. Wherein these facilities required a negative Covid PCR test or required a certain time frame to have elapsed after a positive test prior to accepting or recovering a patient. This study utilized patient records from Keralty Hospital, with admission during the 2022 peak of Omicron (January 31, 2022- February 13, 2022). Patient inclusion criteria was if they had a positive covid test on admission and experienced an extended length of stay over 2 days pending discharge to a long-term care facility. A quantitative/qualitative analysis was conducted of all orders placed subsequent to the first discharge order, and the number of additional days spent at the hospital. Correlations regarding total bed cost, and total overall, were then calculated using single tailed p values utilizing Prism 9 GraphPad software. Our research findings indicate there was a significant correlation between the number of extended hospitalization days and total bed costs but no correlation in the total overall costs or initial length of stay for each patient.

Socio-Economic Impact of COVID-19 Pandemic Among Lower Income Group of People in Pakistan

Objective: To determine the Socio-economic Impact of COVID-19 Pandemic among lower income group of people in Lahore, Pakistan Material and Methods: An analytical cross-sectional study design was used for conducting this research from April 2021 to September 2021 in Lahore and a self-structured questionnaire with multiple variables was filled by 274 participants. Non- Probability type of convenience sampling technique was used for data collection after informed consent. This paper was structured into two sections: The initial part addressed the socio-economic challenges experienced by impoverished individuals amidst the coronavirus pandemic. The subsequent section assessed the current state of Pakistan's healthcare system. Chi-square test was used for qualitative data analysis and p-value &lt;0.05 was taken as significant. Results: Most of the participants (65.7%) in this survey were males and had an income of up to Rs.20,000/ month (70.1%).Out of total, 254 (92.7%) respondents had profound impact of Covid-19 on their lives economically. Majority of them 152(55.5%) visited public places while 133(48.5%) avoided social gatherings like marriages, funerals, religious events etc. during pandemic. More than half of the participants agreed that hospital beds and oxygen were neither available nor it was affordable during their stay at hospital. A significant association was found between family income of respondents and financial crisis faced by respondents when sick with covid-19(p-value=0.05), monthly income suffered due to lockdown or decrease in economy (p-value=0.04) and loan was taken to fulfill their household needs during pandemic (p-value=0.00). Conclusion: The study showed that 254 (92.7%) respondents had profound impact of Covid-19 on their lives economically. A significant association was found between family income of respondents and financial crisis faced by respondents when sick with covid-19, monthly income suffered due to lockdown or decreases in economy and loan taken to fulfill their household needs during pandemic.

Direct Medical Cost for Acute Ischemic Stroke Patients in Vietnam

Ischemic stroke is one of the leading causes of global disease burden. Vietnam, among other low- and middle-income countries, bears nearly 90% of the ischemic stroke burden. This study was a cost-of-illness study conducted from the healthcare system perspective to estimate the direct medical costs and associated factors for acute ischemic stroke patients at Bach Mai Hospital, a major hospital in Hanoi, Vietnam. A total of 500 eligible patients with acute ischemic stroke at the Neurology Department of Bach Mai Hospital from July 2021 to December 2021 were included. Patient characteristics and treatment information were collected via medical records and patient interviews. The majority of the patients were men (65.8%), with a mean age of 65.3 years. The average direct medical cost per patient was 10.5 ± 7.3 million Vietnam Dong (~454.2 ± 313.8 US dollars). The cost of hospital beds accounted for most of the total cost (34.6%), followed by medications and infusion fluid costs (27%) and diagnostic imaging (12.6%). Factors significantly associated with higher direct medical costs were the duration of stay, stroke severity, complications, number of comorbidities, and intravenous thrombolysis treatment. The study highlighted the need for a reduction in the duration of hospital stay and an improvement in onset-to-hospital arrival time.

Analyzing the Capacity of the Healthcare System in Gaza to Address Gaza Residents Needs

The present humanitarian crisis in Gaza has resulted in the devastation of medical facilities and health infrastructure. As of January 2024, the World Health Organization reports that 78% of primary care clinics funded by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA, 2024) have ceased operations, and hospitals’ bed capacity throughout Gaza has decreased by more than 59% (World Health Organization, 2024). Direct military attacks on medical facilities as well as the blockade of medical supplies and humanitarian aid pose the largest obstacles to greater healthcare attainment in Gaza (IRC, 2024). Over the course of the conflict, there has been a surge in the number of people suffering from war injuries, which now totals 71,377 (Shurafa, 2024). The rise in the number of patients who require access to medical services in combination with the limited hospital functionality in the Gaza Strip is putting a massive strain on their already limited healthcare system; before the over 6 month long duration of direct military attacks by the Israeli Defence Forces (IDF) on hospitals in Gaza, data indicated a maximum ratio of 1.55 hospital beds per 1000 individuals across the entire region of the Gaza Strip, while the ratio in the US is around 2.35 hospital beds per 1000 individuals (Taylor, 2024). The already poor living conditions of the demographic–most of whom are housed in temporary structures in severe weather conditions with a lack of access to food and water for sustenance or hygiene–signify a need for a more robust healthcare system. However, triage conditions prioritize treatment of the most severe war injuries, which has forced hospitals to abandon previously established vaccination projects and disease surveillance programs, leaving the remaining population to suffer from preventable diseases such as chickenpox, upper respiratory infections, scabies, and Hepatitis A (Soni, 2024). Individuals who do receive medical care face higher levels of infection due to a lack of adequate sanitation, waste management measures, and basic hygiene supplies (The Economist, 2024).

Identification of a Patient Suitable for CAR-T Cell Therapy in the Outpatient Setting: A Vodcast and Case Example.

Chimeric antigen receptor T cell (CAR-T) therapies targeting the CD19 antigen have been associated with high and durable response rates in patients with diffuse large B cell lymphoma (DLBCL). CAR-T cell therapies are commonly administered in the inpatient setting due to the average onset of cytokine release syndrome within the first 3days post infusion, but there has been growing interest in delivering CAR-T cell therapies in the outpatient setting to overcome frequent hospital bed shortages and the high cost of inpatient care. Although this approach could improve access whilst catering to patient preference, it requires a multidisciplinary approach as well as careful patient selection. Herein, Dr. Foley and Dr. Kuruvilla discuss the case of a patient presenting with the ideal profile for CAR-T cell therapy referral whilst also determining the key attributes for eligibility from a clinician's perspective. Solutions for successful outpatient management include proper education, caregiver support, and early referral to ensure a timely infusion. In conclusion, outpatient administration of CAR-T cell therapy in patients with DLBCLs should be assessed on a case-by-case basis.A vodcast feature is available for this article.

Modelling COVID-19 Vaccination in the UK: Impact of the Autumn 2022 and Spring 2023 Booster Campaigns.

The delivery of COVID-19 vaccines was successful in reducing hospitalizations and mortality. However, emergence of the Omicron variant resulted in increased virus transmissibility. Consequently, booster vaccination programs were initiated to decrease the risk of severe disease and death among vulnerable members of the population. This study aimed to estimate the effects of the booster program and alternative vaccination strategies on morbidity and mortality due to COVID-19 in the UK. A Susceptible-Exposed-Infectious-Recovered (SEIR) model was used to assess the impact of several vaccination strategies on severe outcomes associated with COVID-19, including hospitalizations, mortality, National Health Service (NHS) capacity quantified by hospital general ward and intensive care unit (ICU) bed days, and patient productivity. The model accounted for age-, risk- and immunity-based stratification of the UK population. Outcomes were evaluated over a 48-week time horizon from September 2022 to August 2023 considering the actual UK autumn 2022/spring 2023 booster campaigns and six counterfactual strategies. The model estimated that the autumn 2022/spring 2023 booster campaign resulted in a reduction of 18,921hospitalizations and 1463 deaths, compared with a no booster scenario. Utilization of hospital bed days due to COVID-19 decreased after the autumn 2022/spring 2023 booster campaign. Expanding the booster eligibility criteria and improving uptake improved all outcomes, including averting twice as many ICU admissions, preventing more than 20% additional deaths, and a sevenfold reduction in long COVID, compared with the autumn 2022/spring 2023 booster campaign. The number of productive days lost was reduced by fivefold indicating that vaccinating a wider population has a beneficial impact on the morbidities associated with COVID-19. Our modelling demonstrates that the autumn 2022/spring 2023 booster campaign reduced COVID-19-associated morbidity and mortality. Booster campaigns with alternative eligibility criteria warrant consideration in the UK, given their potential to further reduce morbidity and mortality as future variants emerge.

Outpatient parenteral antibiotic treatment for infective endocarditis: A retrospective observational evaluation

BackgroundInfective endocarditis (IE) requires long courses of intravenous (IV) antibiotics. Outpatient parenteral antibiotic therapy (OPAT) saves resources, improves the patient experience and allows care in their preferred place; however, questions remain about safety when treating IE patients. This study evaluates OPAT management of IE patients in our region between 2006 and 2019. MethodsThis is a retrospective observational evaluation and description of outcomes and adherence to suitability criteria, according to British Society for Antimicrobial Chemotherapy (BSAC) guidelines. ResultsWe identified five models of OPAT delivery. The number of patients treated expanded significantly over time. Of 101 patients, six (6%) suffered poor outcomes, but each patient had contributing factors outside of the primary infection. Median OPAT duration was 12 days and 1,489 hospital bed days were saved. ConclusionsIn a setting where there was good adherence to BSAC criteria, treating IE patients using OPAT services was safe. Complications observed were likely independent of treatment location. Significant bed days were saved.

Impact of an ICU bed capacity optimisation method on the average length of stay and average cost of hospitalisation following implementation of China’s open policy with respect to COVID-19: a difference-in-differences analysis based on information management system data from a tertiary hospital in southwest China

ObjectivesFollowing the implementation of China’s open policy with respect to COVID-19 on 7 December 2022, the influx of patients with infectious diseases has surged rapidly, necessitating hospitals to adopt temporary...

An Adaptive Research Approach to COVID-19 Forecasting for Regional Health Systems in England

A team of researchers worked with public health officials and clinical decision makers to create real-time models to help predict COVID-19 cases and hospital bed needs in the East of England. These models used up-to-date data and allowed officials to explore different scenarios and make informed plans. The models have also been applied in other countries and can be a valuable tool in future epidemics.

Change in the Proportion of Death at Home during the COVID-19 Pandemic and Its Associated Factors in the Municipality Level: A Nationwide Study in Japan.

The coronavirus disease 2019 (COVID-19) pandemic may have led to an increase in home deaths due to hospital bed shortage and hospital visitation restrictions. This study aimed to examine changes in the proportion of home deaths before and after the COVID-19 pandemic and identify associated factors. We used publicly available nationwide data to describe the proportion of home deaths among total deaths from 2015 to 2021. Furthermore, we used municipal-level data to examine the factors associated with the increase in the proportion of home deaths from 2019 to 2021. The dependent variable was the absolute change in the proportion of home deaths from 2019 to 2021. The independent variables included each municipality's 2019 home death percentage, medical and long-term care (LTC) resources divided by the population of older people, population density, and cumulative number of COVID-19 cases. A multivariable linear regression analysis was conducted after the standardization of each variable. The proportions of home deaths in 2015, 2019, and 2021 were 12.7%, 13.6%, and 17.2%, respectively, indicating a sharp increase in home death rate after the COVID-19 pandemic. In the multivariable linear regression analysis that included 1,696 municipalities, conventional home care support clinics and hospitals (HCSCs) (coefficient [95% confidence intervals (CIs)], 0.19 [0.01-0.37]), enhanced HCSCs (0.53 [0.34-0.71]), home-visiting nurses (0.26 [0.06-0.46]), population density (0.44 [0.21-0.67]), and cumulative COVID-19 cases (0.49 [0.27-0.70]) were positively associated with the increase in home deaths, whereas beds of LTC welfare facilities (-0.55 [-0.74--0.37]) and the proportion of home deaths in 2019 (-1.24 [-1.44--1.05]) were negatively associated with the increase. During the COVID-19 pandemic, home deaths significantly increased, particularly in densely populated areas with high cumulative COVID-19 cases. HCSCs, especially enhanced HCSCs, are crucial for meeting the demand for home-based end-of-life care.