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

Autor:	Burton JK; Academic Geriatric Medicine, School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, GlasgowG31 2ER, UK., McMinn M; Public Health Scotland, Glasgow G2 6QE, UK.; Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK., Vaughan JE; School of Informatics, University of Edinburgh, Edinburgh EH8 9AB, UK., Nightingale G; Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9AB, UK., Fleuriot J; Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK.; Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK., Guthrie B; Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2024 Feb 01; Vol. 53 (2).
DOI:	10.1093/ageing/afae015
Abstrakt:	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. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.)
Databáze:	MEDLINE
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