ABSTRACT

The Coronavirus disease 2019 (COVID-19) disproportionately affects nursing home residents, resulting in an elevated risk for COVID-19 morbidity and mortality for this frail population. It is critical to understand whether nursing home quality is related to COVID-19 cases and deaths. Using publicly available data obtained from Centers for Medicare & Medicaid Services COVID-19 Nursing Home Dataset, Nursing Home Compare and Long-Term Care Focus, this study compares key nursing home characteristics, infection prevention and control deficiencies, and five-star ratings among Florida nursing homes with and without resident COVID-19 cases and deaths. The study further examines the association between facility and resident characteristics, quality indicators, and COVID-19 cases and deaths. Findings from our study indicate that through late October 2020, over 90% of Florida nursing homes have at least one resident case and 65% have at least one resident death. The likelihood of having COVID-19 cases is more related to ownership status, facility size and average occupancy rate, rather than quality indicators. Associations between infection prevention and control deficiencies, overall quality ratings, and presence of COVID-19 resident deaths varied across different phases of the pandemic (e.g., overall five-star rating was found related to the odds of having resident deaths after, but not during, the surging stage). Training, uptake, and adherence to infection control procedures are needed to better protect the vulnerable nursing home resident population.

摘要

2019 年冠状病毒病 (COVID-19) 对疗养院居民的影响不成比例，导致这一体弱人群的 COVID-19 发病率和死亡率风险升高。了解疗养院质量是否与 COVID-19 病例和死亡有关至关重要。本研究使用从医疗保险和医疗补助服务中心 COVID-19 疗养院数据集、疗养院比较和长期护理焦点获得的公开数据，比较佛罗里达州的关键疗养院特征、感染预防和控制缺陷以及五星级评级有和没有居民 COVID-19 病例和死亡的疗养院。该研究进一步检查了设施和居民特征、质量指标以及 COVID-19 病例和死亡之间的关联。我们的研究结果表明，到 2020 年 10 月下旬，佛罗里达州 90% 以上的疗养院至少有 1 例居民病例，65% 的疗养院至少有 1 例居民死亡。出现 COVID-19 病例的可能性更多地与所有权状况、设施规模和平均入住率有关，而不是质量指标。感染预防和控制缺陷、整体质量评级和 COVID-19 居民死亡的存在之间的关联在大流行的不同阶段各不相同（例如，发现总体五星级与居民死亡的几率有关，但与期间无关，澎湃阶段）。需要培训、接受和遵守感染控制程序，以更好地保护脆弱的疗养院常住人口。出现 COVID-19 病例的可能性更多地与所有权状况、设施规模和平均入住率有关，而不是质量指标。感染预防和控制缺陷、整体质量评级和 COVID-19 居民死亡的存在之间的关联在大流行的不同阶段各不相同（例如，发现总体五星级与居民死亡的几率有关，但与期间无关，澎湃阶段）。需要培训、接受和遵守感染控制程序，以更好地保护脆弱的疗养院常住人口。出现 COVID-19 病例的可能性更多地与所有权状况、设施规模和平均入住率有关，而不是质量指标。感染预防和控制缺陷、整体质量评级和 COVID-19 居民死亡的存在之间的关联在大流行的不同阶段各不相同（例如，发现总体五星级与居民死亡的几率有关，但与期间无关，澎湃阶段）。需要培训、接受和遵守感染控制程序，以更好地保护脆弱的疗养院常住人口。并且 COVID-19 居民死亡的存在在大流行的不同阶段有所不同（例如，发现总体五星级与居民死亡的几率有关，而不是在激增阶段）。需要培训、接受和遵守感染控制程序，以更好地保护脆弱的疗养院常住人口。并且 COVID-19 居民死亡的存在在大流行的不同阶段有所不同（例如，发现总体五星级与居民死亡的几率有关，而不是在激增阶段）。需要培训、接受和遵守感染控制程序，以更好地保护脆弱的疗养院常住人口。