Hello @HeideNei and welcome to OHDSI and the OMOP CDM!
As Christian states, if a Death occurs during a hospitalization, you will have a Death record and Visit Occurrence record on the same day. If the Death occurs at home, the Death date and Visit dates won’t overlap. This is the cleanest and easiest way for researchers to determine if the death happens at the hospital or at home. Sure, you can take it a step further and add in an additional record in the Observation table, but when it comes to clinical event data, most folks take their source values and map them to standard concept_ids before inserting in the clinical event tables. And most source systems do not have SNOMED code = 16983000 and most sites do not add in this additional step to create these records during the ETL process. ETLing data to the OMOP CDM is quite the large undertaking. Making it more complex by trying to represent every fact in obscure ways isn’t advisable. Especially for your first ETL. Take the pragmatic approach and ETL the basic data. If your researchers (concept_id = 16983000 won’t be use in a network study) still have an unmet need, then add in this additional row of data.
Per the conventions in CDM v5.4 “The death domain contains the clinical event for how and when a Person dies”. So, if you have a death record it must go in the death table. If you have additional attributes or details about a death, such as died in hospital, you can use another standard concept_id to represent these details.
@Christian_Reich I don’t think we should de-standardize concept_id = 4061268. We could add stronger language to the Death table. Something along the lines, “if you have a death record it must go in the death table. If you have additional attributes or details about a death, you can use another standard concept_id in its given domain to represent these details”.