BMC Emerg Med 21, 55 (2021). https://doi.org/10.1186/s12873-021-00450-2
- A review of the entire pathway of care of patients (n=552) whose death was registered in Salford during the 8 week period of the first wave (primary care, secondary care, 111 and 999 calls) was carried out in order to create a single record of healthcare prior to death.
- 18% of deaths contained themes consistent with some degree of avoidability. In people aged ≥75 years who lived at home this was 53%, in care home residents 29% and in patients with learning disability 44% (n = 9). Common themes were; delays in patients presenting to care providers (10%), delays in testing (17%), avoidable exposure to COVID-19 (26%), delays in provider response (5%), and sub-optimal care (11%). For avoidability scores of 2 or 3 (indicating more than 50% chance of avoidability), 44% of cases had > 2 themes.
