Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes

Objective Nursing homes’ residents and staff constitute the largest proportion of the fatalities associated with COVID-19 epidemic. Although there is a significant variation in COVID-19 outbreaks among the US nursing homes, we still do not know why such outbreaks are larger and more likely in some n...

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Autores principales:	Ram Gopal, Xu Han, Niam Yaraghi
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/c29f22f27f2c4014b2451ebfa8f6ce83
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spelling	oai:doaj.org-article:c29f22f27f2c4014b2451ebfa8f6ce832021-11-18T16:00:05ZCompress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes10.1136/bmjopen-2020-0428042044-6055https://doaj.org/article/c29f22f27f2c4014b2451ebfa8f6ce832021-01-01T00:00:00Zhttps://bmjopen.bmj.com/content/11/1/e042804.fullhttps://doaj.org/toc/2044-6055Objective Nursing homes’ residents and staff constitute the largest proportion of the fatalities associated with COVID-19 epidemic. Although there is a significant variation in COVID-19 outbreaks among the US nursing homes, we still do not know why such outbreaks are larger and more likely in some nursing homes than others. This research aims to understand why some nursing homes are more susceptible to larger COVID-19 outbreaks.Design Observational study of all nursing homes in the state of California until 1 May 2020.Setting The state of California.Participants 713 long-term care facilities in the state of California that participate in public reporting of COVID-19 infections as of 1 May 2020 and their infections data could be matched with data on ratings and governance features of nursing homes provided by Centers for Medicare & Medicaid Services (CMS).Main outcome measure The number of reported COVID-19 infections among staff and residents.Results Study sample included 713 nursing homes. The size of outbreaks among residents in for-profit nursing homes is 12.7 times larger than their non-profit counterparts (log count=2.54; 95% CI, 1.97 to 3.11; p<0.001). Higher ratings in CMS-reported health inspections are associated with lower number of infections among both staff (log count=−0.19; 95% CI, −0.37 to −0.01; p=0.05) and residents (log count=−0.20; 95% CI, −0.27 to −0.14; p<0.001). Nursing homes with higher discrepancy between their CMS-reported and self-reported ratings have higher number of infections among their staff (log count=0.41; 95% CI, 0.31 to 0.51; p<0.001) and residents (log count=0.13; 95% CI, 0.08 to 0.18; p<0.001).Conclusions The size of COVID-19 outbreaks in nursing homes is associated with their ratings and governance features. To prepare for the possible next waves of COVID-19 epidemic, policy makers should use these insights to identify the nursing homes who are more likely to experience large outbreaks.Ram GopalXu HanNiam YaraghiBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 11, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Ram Gopal Xu Han Niam Yaraghi Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes
description	Objective Nursing homes’ residents and staff constitute the largest proportion of the fatalities associated with COVID-19 epidemic. Although there is a significant variation in COVID-19 outbreaks among the US nursing homes, we still do not know why such outbreaks are larger and more likely in some nursing homes than others. This research aims to understand why some nursing homes are more susceptible to larger COVID-19 outbreaks.Design Observational study of all nursing homes in the state of California until 1 May 2020.Setting The state of California.Participants 713 long-term care facilities in the state of California that participate in public reporting of COVID-19 infections as of 1 May 2020 and their infections data could be matched with data on ratings and governance features of nursing homes provided by Centers for Medicare & Medicaid Services (CMS).Main outcome measure The number of reported COVID-19 infections among staff and residents.Results Study sample included 713 nursing homes. The size of outbreaks among residents in for-profit nursing homes is 12.7 times larger than their non-profit counterparts (log count=2.54; 95% CI, 1.97 to 3.11; p<0.001). Higher ratings in CMS-reported health inspections are associated with lower number of infections among both staff (log count=−0.19; 95% CI, −0.37 to −0.01; p=0.05) and residents (log count=−0.20; 95% CI, −0.27 to −0.14; p<0.001). Nursing homes with higher discrepancy between their CMS-reported and self-reported ratings have higher number of infections among their staff (log count=0.41; 95% CI, 0.31 to 0.51; p<0.001) and residents (log count=0.13; 95% CI, 0.08 to 0.18; p<0.001).Conclusions The size of COVID-19 outbreaks in nursing homes is associated with their ratings and governance features. To prepare for the possible next waves of COVID-19 epidemic, policy makers should use these insights to identify the nursing homes who are more likely to experience large outbreaks.
format	article
author	Ram Gopal Xu Han Niam Yaraghi
author_facet	Ram Gopal Xu Han Niam Yaraghi
author_sort	Ram Gopal
title	Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes
title_short	Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes
title_full	Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes
title_fullStr	Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes
title_full_unstemmed	Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes
title_sort	compress the curve: a cross-sectional study of variations in covid-19 infections across california nursing homes
publisher	BMJ Publishing Group
publishDate	2021
url	https://doaj.org/article/c29f22f27f2c4014b2451ebfa8f6ce83
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Compress the curve: a cross-sectional study of variations in COVID-19 infections across California nursing homes

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