tetano
Editor, Senior Moderator
J Am Geriatr Soc
. 2020 Sep 21.
doi: 10.1111/jgs.16847. Online ahead of print.
Racial and ethnic disparities in COVID-19 infections and deaths across U.S. nursing homes
Yue Li[SUP] 1 [/SUP], Xi Cen[SUP] 2 [/SUP], Xueya Cai[SUP] 3 [/SUP], Helena Temkin-Greener[SUP] 1 [/SUP]
Affiliations
Abstract
Background/objectives: To determine racial/ethnic disparities in weekly counts of new coronavirus disease 2019 (COVID-19) cases and deaths among nursing home residents or staff.
Design: Cross-sectional analysis of national nursing home COVID-19 reports linked to other data. Multivariable two-part models modeled disparities in count of cases or deaths and logistic regressions modeled disparities in self-reported shortages in staff and personal protective equipment (PPE), across nursing home groups with varying proportions of racial/ethnic minority residents, defined as low-, medium-, medium-high-, and high-proportion groups.
Setting: 12,576 nursing homes nationally PARTICIPANTS: None.
Intervention: None.
Measurements: Numbers of incident COVID-19 confirmed cases among residents and staff, and incident COVID-19 related deaths among residents (primary outcomes); and nursing home reported shortages in staff and PPE (secondary outcomes). All outcomes were reported for the week of May 25, 2020.
Results: The number of weekly new COVID-19 confirmed cases among residents ranged from an average of 0.4 cases per facility (SD=2.5) for the low-proportion group (93.0% had zero new case) to 1.5 cases per facility (SD=6.3) for the high-proportion group (78.9% had zero new case). Multivariable regression estimated that compared to the low-proportion group, the likelihood of having at least one new resident case was 76% higher (odds ratio [OR]=1.76, 95% confidence interval [CI] 1.38-2.25, p=0.000) for the high-proportion group. Similar across-facility disparities were found for the weekly count of new COVID-19 deaths among residents (ranging from 0.1 deaths per facility [SD=1.1] for the low-proportion group to 0.4 deaths [SD=2.0] for the high-proportion group) and in the weekly count of new COVID-19 confirmed cases among staff (ranging from 0.3 cases [SD=1.4] to 1.3 cases [SD=4.4] per facility). No substantial disparities in self-reported shortages of staff or PPE were found.
Conclusion: Nursing homes caring for disproportionately more racial/ethnic minority residents reported more weekly new COVID-19 confirmed cases and/or deaths. Immediate actions are needed to address these system-level disparities.
Keywords: COVID-19; coronavirus; disparity; nursing home; race and ethnicity.
. 2020 Sep 21.
doi: 10.1111/jgs.16847. Online ahead of print.
Racial and ethnic disparities in COVID-19 infections and deaths across U.S. nursing homes
Yue Li[SUP] 1 [/SUP], Xi Cen[SUP] 2 [/SUP], Xueya Cai[SUP] 3 [/SUP], Helena Temkin-Greener[SUP] 1 [/SUP]
Affiliations
- PMID: 32955105
- DOI: 10.1111/jgs.16847
Abstract
Background/objectives: To determine racial/ethnic disparities in weekly counts of new coronavirus disease 2019 (COVID-19) cases and deaths among nursing home residents or staff.
Design: Cross-sectional analysis of national nursing home COVID-19 reports linked to other data. Multivariable two-part models modeled disparities in count of cases or deaths and logistic regressions modeled disparities in self-reported shortages in staff and personal protective equipment (PPE), across nursing home groups with varying proportions of racial/ethnic minority residents, defined as low-, medium-, medium-high-, and high-proportion groups.
Setting: 12,576 nursing homes nationally PARTICIPANTS: None.
Intervention: None.
Measurements: Numbers of incident COVID-19 confirmed cases among residents and staff, and incident COVID-19 related deaths among residents (primary outcomes); and nursing home reported shortages in staff and PPE (secondary outcomes). All outcomes were reported for the week of May 25, 2020.
Results: The number of weekly new COVID-19 confirmed cases among residents ranged from an average of 0.4 cases per facility (SD=2.5) for the low-proportion group (93.0% had zero new case) to 1.5 cases per facility (SD=6.3) for the high-proportion group (78.9% had zero new case). Multivariable regression estimated that compared to the low-proportion group, the likelihood of having at least one new resident case was 76% higher (odds ratio [OR]=1.76, 95% confidence interval [CI] 1.38-2.25, p=0.000) for the high-proportion group. Similar across-facility disparities were found for the weekly count of new COVID-19 deaths among residents (ranging from 0.1 deaths per facility [SD=1.1] for the low-proportion group to 0.4 deaths [SD=2.0] for the high-proportion group) and in the weekly count of new COVID-19 confirmed cases among staff (ranging from 0.3 cases [SD=1.4] to 1.3 cases [SD=4.4] per facility). No substantial disparities in self-reported shortages of staff or PPE were found.
Conclusion: Nursing homes caring for disproportionately more racial/ethnic minority residents reported more weekly new COVID-19 confirmed cases and/or deaths. Immediate actions are needed to address these system-level disparities.
Keywords: COVID-19; coronavirus; disparity; nursing home; race and ethnicity.