Department of Geriatrics, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.
CIBERFES, Ministerio de Economía y Competitividad, Madrid, Spain.
PLoS One. 2020 Oct 27;15(10):e0241030. doi: 10.1371/journal.pone.0241030. eCollection 2020.
BACKGROUND/OBJECTIVES: To analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain.
Epidemiological study.
Six open LTCFs in Albacete (Spain).
198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents.
Baseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed.
The pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals.
The COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high.
背景/目的：分析西班牙 COVID-19 爆发期间六家长期护理机构（LTCF）的死亡率、成本、居民和人员特征。
流行病学研究。
西班牙阿尔瓦塞特的六家长期开放护理机构。
2020 年 3 月 6 日至 4 月 5 日期间，共纳入 LTCF A 的 198 名居民和 190 名工作人员。同时还收集了同一时期阿尔瓦塞特六家长期护理机构的流行病学数据，包括 1084 名居民。
收集基线人口统计学、临床、功能、认知和营养变量。确定 1 个月和 3 个月的死亡率，计算超额死亡率，并分析与大流行相关的成本。
疫情爆发第一个月和前三个月的总死亡率分别为 15.3%和 28.0%，同期超额死亡率分别为 564%和 315%。在机构 A，疑似 COVID-19 感染居民的比例为 33.6%。疑似感染患者比没有 COVID-19 的患者年龄更大、身体更虚弱，功能状况更差。最常见的症状是发烧、咳嗽和呼吸困难。有 25 名居民被转至急诊部，21 名住院，54 名被转移至机构医疗部门。死亡率较高的是年龄较大的男性居民，且功能更差，合并症更多。疫情爆发的第一个月，有 65 名（24.6%）工作人员离职，主要是因为出现 COVID-19 症状，同时招聘了 69 名新员工。平均休假天数为 19.2 天。机构 A 因 COVID-19 造成的费用估计为每月 276,281 欧元，主要用于居民住院、员工缺勤、人员更替以及医护人员的干预。
COVID-19 大流行使居民面临高死亡率风险，主要是那些年龄较大、身体虚弱且功能状态较差的居民。个人和经济成本都很高。
