SARS-CoV-2 and Wisconsin Nursing Homes: Temporal Dynamics During the COVID-19 Pandemic |
| |
| Affiliation: | 1. Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA;2. Research Group Innovación y Cuidado, Faculty of Nursing, Universidad Antonio Nariño, Neiva, Colombia;3. Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, Milwaukee, WI, USA;4. Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA;5. Froedtert Health, Milwaukee, WI, USA;6. Division of Geriatrics and Palliative Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA |
| |
| Abstract: | ObjectivesEvidence suggests that quality, location, and staffing levels may be associated with COVID-19 incidence in nursing homes. However, it is unknown if these relationships remain constant over time. We describe incidence rates of COVID-19 across Wisconsin nursing homes while examining factors associated with their trajectory during 5 months of the pandemic.DesignRetrospective cohort study.Setting/ParticipantsWisconsin nursing homes.MethodsPublicly available data from June 1, 2020, to October 31, 2020, were obtained. These included facility size, staffing, 5-star Medicare rating score, and components. Nursing home characteristics were compared using Pearson chi-square and Kruskal-Wallis tests. Multiple linear regressions were used to evaluate the effect of rurality on COVID-19.ResultsThere were a total of 2459 COVID-19 cases across 246 Wisconsin nursing homes. Number of beds (P < .001), average count of residents per day (P < .001), and governmental ownership (P = .014) were associated with a higher number of COVID-19 cases. Temporal analysis showed that the highest incidence rates of COVID-19 were observed in October 2020 (30.33 cases per 10,000 nursing home occupied-bed days, respectively). Urban nursing homes experienced higher incidence rates until September 2020; then incidence rates among rural nursing homes surged. In the first half of the study period, nursing homes with lower-quality scores (1-3 stars) had higher COVID-19 incidence rates. However, since August 2020, incidence was highest among nursing homes with higher-quality scores (4 or 5 stars). Multivariate analysis indicated that over time rural location was associated with increased incidence of COVID-19 (β = 0.05, P = .03).Conclusions and ImplicationsHigher COVID-19 incidence rates were first observed in large, urban nursing homes with low-quality rating. By October 2020, the disease had spread to rural and smaller nursing homes and those with higher-quality ratings, suggesting that community transmission of SARS-CoV-2 may have propelled its spread. |
| |
| Keywords: | COVID-19 SARS-CoV-2 nursing homes quality 5-star rating |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
