Ram Gopal 1 , Xu Han 2 , Niam Yaraghi 3,4 Show Affiliations »
Abstract
OBJECTIVE: Nursing homes' residents and staff constitute the largest proportion of the fatalities associated with COVID-19 epidemic. Although there is a significant variation in COVID-19 outbreaks among the US nursing homes, we still do not know why such outbreaks are larger and more likely in some nursing homes than others. This research aims to understand why some nursing homes are more susceptible to larger COVID-19 outbreaks. DESIGN: Observational study of all nursing homes in the state of California until 1 May 2020. SETTING: The state of California. PARTICIPANTS: 713 long-term care facilities in the state of California that participate in public reporting of COVID-19 infections as of 1 May 2020 and their infections data could be matched with data on ratings and governance features of nursing homes provided by Centers for Medicare & Medicaid Services (CMS). MAIN OUTCOME MEASURE: The number of reported COVID-19 infections among staff and residents. RESULTS: Study sample included 713 nursing homes. The size of outbreaks among residents in for-profit nursing homes is 12.7 times larger than their non-profit counterparts (log count=2.54; 95% CI, 1.97 to 3.11; p<0.001). Higher ratings in CMS-reported health inspections are associated with lower number of infections among both staff (log count=-0.19; 95% CI, -0.37 to -0.01; p=0.05) and residents (log count=-0.20; 95% CI, -0.27 to -0.14; p<0.001). Nursing homes with higher discrepancy between their CMS-reported and self-reported ratings have higher number of infections among their staff (log count=0.41; 95% CI, 0.31 to 0.51; p<0.001) and residents (log count=0.13; 95% CI, 0.08 to 0.18; p<0.001). CONCLUSIONS: The size of COVID-19 outbreaks in nursing homes is associated with their ratings and governance features. To prepare for the possible next waves of COVID-19 epidemic, policy makers should use these insights to identify the nursing homes who are more likely to experience large outbreaks. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
OBJECTIVE: Nursing homes' residents and staff constitute the largest proportion of the fatalities associated with COVID-19 epidemic. Although there is a significant variation in COVID-19 outbreaks among the US nursing homes, we still do not know why such outbreaks are larger and more likely in some nursing homes than others. This research aims to understand why some nursing homes are more susceptible to larger COVID-19 outbreaks. DESIGN: Observational study of all nursing homes in the state of California until 1 May 2020. SETTING: The state of California. PARTICIPANTS : 713 long-term care facilities in the state of California that participate in public reporting of COVID-19 infections as of 1 May 2020 and their infections data could be matched with data on ratings and governance features of nursing homes provided by Centers for Medicare & Medicaid Services (CMS). MAIN OUTCOME MEASURE: The number of reported COVID-19 infections among staff and residents. RESULTS: Study sample included 713 nursing homes. The size of outbreaks among residents in for-profit nursing homes is 12.7 times larger than their non-profit counterparts (log count=2.54; 95% CI, 1.97 to 3.11; p<0.001). Higher ratings in CMS-reported health inspections are associated with lower number of infections among both staff (log count=-0.19; 95% CI, -0.37 to -0.01; p=0.05) and residents (log count=-0.20; 95% CI, -0.27 to -0.14; p<0.001). Nursing homes with higher discrepancy between their CMS-reported and self-reported ratings have higher number of infections among their staff (log count=0.41; 95% CI, 0.31 to 0.51; p<0.001) and residents (log count=0.13; 95% CI, 0.08 to 0.18; p<0.001). CONCLUSIONS: The size of COVID-19 outbreaks in nursing homes is associated with their ratings and governance features. To prepare for the possible next waves of COVID-19 epidemic, policy makers should use these insights to identify the nursing homes who are more likely to experience large outbreaks. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Disease
Gene
Species
Keywords:
COVID-19; geriatric medicine; health policy
Year: 2021
PMID： 33408208 DOI： 10.1136/bmjopen-2020-042804
Source DB: PubMed Journal: BMJ Open ISSN： 2044-6055 Impact factor: 2.692