Why does the place where people receive care and die matter so much, and how can better data help improve end-of-life care worldwide?
Where people spend the final phase of their lives is much more than a practical or medical matter. The place where care is received and where a person eventually dies often holds deep personal meaning. For some, that place is home, surrounded by family and familiar belongings. For others, a healthcare facility offers the comfort, safety, and support they need. Preferences and circumstances vary from person to person, but for everyone, the environment can shape the experience of the end of life. At the same time, we still know relatively little about where people spend their final phase of life and where they die. Data collection and registration systems differ between countries, making international comparisons difficult. The international research project EOLinPLACE aims to address this gap by improving our understanding of the relationship between people, care, and the places where end-of-life experiences unfold.
The EOLinPLACE Project (End‑of‑Life in Place) is an international research initiative designed to understand, measure, and improve where people receive end‑of‑life care and where they die. The project is led by Prof Barbara Gomes, Floriani Chair in Palliative Care at the University of Coimbra in Portugal, and brings together global experts in palliative care, public health, bioethics, epidemiology, and health systems to create a standardised, comparable way of capturing this information across countries. The work is funded by the European Research Council.
The EOLinPLACE is the project that developed and validated the International Classification of Dying Places (ICP)—the first global, person‑centred classification system about an end-of-life care matter, endorsed in March 2026 by the United Nations Statistical Commission as an international classification. Alongside the ICP, the project has been generating evidence through studies that explore disparities of dying places across different ages, diagnoses, countries, health systems, etc., in order to identify gaps, inequities and opportunities for systems strengthening.
EOLinPLACE recognises that:
- Dying is an individual, relational and contextual experience
- Place carries emotional, cultural, social, and identity‑based meaning
- People deserve to be cared for—and to die—where they feel safe and supported
By capturing these realities in a standardised way, the project is helping shift global health systems toward compassion, dignity, and person‑centred care.
The International Classification of Dying Places (ICP) offers a shared global framework and vocabulary for describing and understanding “dying places”—both the locations where people die (babies, children, adolescents and adults) and the places where they receive care at the end of life. While death itself is a single event that occurs in one place and may happen unexpectedly, most people experience an end‑of‑life period that unfolds over weeks or months due to illness.
Place of death is a crucial population‑level statistic. It guides health and social policy, informs resource allocation, and helps ensure that services—including palliative care—are available where people actually die. Each year, an estimated 27 million people worldwide die with serious health‑related suffering that could benefit from palliative care, a number expected to double by 2060. Place of death also matters for other causes of mortality, such as injuries or self‑harm. Whenever possible, people should be able to receive end‑of‑life care and die in the place that feels right for them. Data on dying places therefore reveal how well health systems and societies support patient and family preferences.
The ICP addresses the need for an internationally consistent and standardized way to classify data on dying places. Although many countries already record place of death on death certificates or in civil registration systems, existing classifications are incomplete and inconsistent. As a result, international comparisons are often limited to broad categories such as “home” versus “hospital,” and even these comparisons lack rigour due to variation in definitions and what each category includes.
A major global reform of classification systems provides an opportunity to harmonize information so that countries can generate comparable data. Given the rapidly growing need for palliative care in the post‑pandemic era, this reform is timely. The potential benefits of accurately capturing where people die are enormous: better data can transform records, strengthen health systems, and improve care for everyone.
The ICP offers a comprehensive, hierarchical list of dying places designed to reflect what matters to individuals at the end of life. It goes beyond medical settings to include the social, emotional, and personal meanings attached to where people spend their final months, weeks, days, and hours—such as safety, privacy, identity, and connection to family life.
Summarised structure of the ICP
Dying Places
A. Dwelling of Domicile
A01. Individual
A02. Collective
A03. Other
B. Health or Care Facility
B01. Hospital
B0101. Emergency department
B0102. Intensive care unit
B0103. Palliative care unit or hospice within hospital
B0104. Other inpatient unit (specify)
B0105. Other (specify)
B0106. Area unknown
B02. Long-term care facility or nursing home
B0201. Palliative care unit or hospice within long-term care facility or nursing home
B0208. Other (specify)
B0209. Area unknown
B03. Palliative care facility or hospice facility
B04. Primary care facility or community health centre
B08. Other (specify)
C. Other facility
D. Vehicle
E. Outdoor
F. Elsewhere (specify)
G. Unknown
You can find out more on the project website.