Inequities in the incidence and mortality due to COVID-19 in nursing homes in Barcelona by characteristics of the nursing homes

Torres, Mayara Louise; Palma, David; Oliver-Parra, Alba; Millet, Joan-Pau; Cosialls, Delfí; Guillaumes, Montserrat; Rius, Cristina; Vásquez-Vera, Hugo

doi:10.1371/journal.pone.0269639

Cited by 8 publications

(7 citation statements)

References 36 publications

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“…A large international literature has identified a number of factors associated with Covid-19 outbreaks in LTRC settings including facility size, form of ownership and community rates of Covid-19 (Konetzka et al, 2021;Frazer et al, 2021). Larger LTRC homes (Aalto et al, 2022;Konetzka et al, 2021) and homes with higher rates of occupancy (Dutey-Magni et al, 2021;Torres et al, 2022) have been found to have more Covid-19 outbreaks and higher Covid-19 mortality rates. Although the probability of an outbreak increased with the size of the facility, higher nurse-resident ratios were shown to reduce spread of Covid-19 infection once it entered a facility (Dutey-Magni et al, 2021;Figueroa et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Covid-19 in the Community and Outbreaks in Long-Term Residential Care in Ireland

Walsh¹,

Connolly

Wren

2023

JLTC

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Context: Long-term residential care (LTRC) has been disproportionately impacted by Covid-19, with two-thirds of Covid-19 deaths occurring in LTRC homes in Ireland. Objectives: The study aims to examine the factors associated with LTRC Covid-19 outbreaks in Ireland. Methods: We merged data on Covid-19 cases and deaths in the community and LTRC homes with LTRC home characteristics across Waves 1-3 of the pandemic. Analyses examined the impact LTRC home characteristics and proximity to high community Covid-19 rates had on the likelihood of Covid-19 outbreaks and severity of outbreaks in LTRC homes. Findings: 8,502 confirmed cases of Covid-19 among LTRC home residents were recorded. Two thirds of LTRC homes had a Covid-19 outbreak across the first three waves of the pandemic. Larger LTRC homes were three times more likely to have an outbreak than smaller homes. High local community Covid-19 rates significantly increased the probability of a LTRC home outbreak. Homes in areas with the highest community Covid-19 rates were almost seven times more likely to have an outbreak than LTRC homes located in areas with the lowest community Covid-19 rates. Limitations: No centralised dataset exists in Ireland that collects information on morbidity, dementia or cognitive status of had on residents. Implications: Covid-19 had a significant impact on LTRC in Ireland with very high rates of cases and deaths. Our findings suggest that while factors such as home size may have increased the probability of an outbreak, being located in areas with high levels of community Covid-19 cases was likely the key factor explaining LTRC outbreaks.

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Section: Introductionmentioning

confidence: 99%

Covid-19 in the Community and Outbreaks in Long-Term Residential Care in Ireland

Walsh¹,

Connolly

Wren

2023

JLTC

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“…The environmental factors frequently emerged and supported by a substantial body of evidence linked to outbreaks include a higher number of beds, occupancy rate [21,25,26,30,31,34,47,54,56,60,61,63,65,67,72,73,[82][83][84]91,94,97,106], presence of outbreaks in surrounding counties/communities [6,26,[29][30][31]37,38,60,69,79,80,84,91,93,99,104], high-density communities [21,29,56,67,73,106] socioeconomic status of the community, [24,64,77,84,…”

Section: Environmental Factors Related To Covid Outbreaksmentioning

confidence: 99%

“…The environmental factors frequently associated with mortality include occupancy, levels of crowding [2,25,56,64,83,94,98,104], the larger size of the facility or the number of beds in the LTCF [2,32,33,62,63,65], the location of the LTCF [2,21,24,62,87], higher community or county incidences [60,77,80,104,113], and structural design of the rooms or number of beds in a room [21,25,66,113].…”

Section: Environmental Factors Related To Covid-related Deathsmentioning

confidence: 99%

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review

Karimi-Dehkordi,

Hanson,

Silvius

et al. 2024

Healthcare

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This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities (LTCFs). A systematic review was conducted to summarize and synthesize empirical studies using a multi-level analysis approach to address the identified influential factors. Five databases were searched on 23 May 2023. To be included in the review, studies had to be published in peer-reviewed journals or as grey literature containing relevant statistical data. The Joanna Briggs Institute critical appraisal tool was employed to assess the methodological quality of each article included in this study. Of 2137 citations identified after exclusions, 99 records met the inclusion criteria. The predominant individual, organizational, and environmental factors that were most frequently found associated with the COVID-19 outbreak comprised older age, higher dependency level; lower staffing levels and lower star and subset domain ratings for the facility; and occupancy metrics and co-occurrences of outbreaks in counties and communities where the LTCFs were located, respectively. The primary individual, organizational, and environmental factors frequently linked to COVID-19-related deaths comprised age, and male sex; higher percentages of racial and ethnic minorities in LTCFs, as well as ownership types (including private, for-profit, and chain membership); and higher occupancy metrics and LTCF’s size and bed capacity, respectively. Unfolding the risk factors collectively may mitigate the risk of outbreaks and pandemic-related mortality in LTCFs during future endemic and pandemics through developing and improving interventions that address those significant factors.

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“…In Wales, longitudinal cohort analyses has examined risk factors for infections, including age, community prevalence and hospital admission [ 15 , 16 ]. Internationally, variables such as neighbourhood socio-economic position, occupancy, ownership and crowding have been examined [ 6 , 17–19 ]. Although international comparisons are complicated by structural and contextual differences in the configuration of care services [ 20 ], large care-home outbreaks are a common feature of periods whenever COVID community incidence is high [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the impact of COVID-19 on Scotland’s care-homes from March 2020 to October 2021: national linked data cohort analysis

Burton,

McMinn,

Vaughan

et al. 2024

Age and Ageing

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Background The impact of the COVID-19 pandemic on long-term care residents remains of wide interest, but most analyses focus on the initial wave of infections. Objective To examine change over time in: (i) The size, duration, classification and pattern of care-home outbreaks of COVID-19 and associated mortality and (ii) characteristics associated with an outbreak. Design Retrospective observational cohort study using routinely-collected data. Setting All adult care-homes in Scotland (1,092 homes, 41,299 places). Methods Analysis was undertaken at care-home level, over three periods. Period (P)1 01/03/2020-31/08/2020; P2 01/09/2020-31/05/2021 and P3 01/06/2021–31/10/2021. Outcomes were the presence and characteristics of outbreaks and mortality within the care-home. Cluster analysis was used to compare the pattern of outbreaks. Logistic regression examined care-home characteristics associated with outbreaks. Results In total 296 (27.1%) care-homes had one outbreak, 220 (20.1%) had two, 91 (8.3%) had three, and 68 (6.2%) had four or more. There were 1,313 outbreaks involving residents: 431 outbreaks in P1, 559 in P2 and 323 in P3. The COVID-19 mortality rate per 1,000 beds fell from 45.8 in P1, to 29.3 in P2, and 3.5 in P3. Larger care-homes were much more likely to have an outbreak, but associations between size and outbreaks were weaker in later periods. Conclusions COVID-19 mitigation measures appear to have been beneficial, although the impact on residents remained severe until early 2021. Care-home residents, staff, relatives and providers are critical groups for consideration and involvement in future pandemic planning.

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Inequities in the incidence and mortality due to COVID-19 in nursing homes in Barcelona by characteristics of the nursing homes

Cited by 8 publications

References 36 publications

Covid-19 in the Community and Outbreaks in Long-Term Residential Care in Ireland

Covid-19 in the Community and Outbreaks in Long-Term Residential Care in Ireland

Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review

Analysis of the impact of COVID-19 on Scotland’s care-homes from March 2020 to October 2021: national linked data cohort analysis

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