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疫情期间养老院中的 COVID-19 疫情爆发:英国国家医疗服务体系质量监管局的评级能否很好地预测高风险养老院?

COVID-19 outbreaks in care homes during the first wave: are Care Quality Commission ratings a good predictor of at-risk homes?

机构信息

Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Public Health England, Liverpool, UK.

Public Health England, Liverpool, UK.

出版信息

J Hosp Infect. 2021 May;111:96-101. doi: 10.1016/j.jhin.2020.12.023. Epub 2021 Jan 13.

Abstract

BACKGROUND

COVID-19 placed a significant burden on the care home population during the first wave. Care Quality Commission's care quality ratings are given to all English care homes and could be used to identify whether care homes are at risk of COVID-19 outbreaks.

METHODS

An audit was performed, April 2020, of Liverpool care homes to identify associations between COVID-19 status and care quality ratings from the Care Quality Commission. Univariable logistic regression was performed to identify whether the Care Quality Commissions ratings were associated with a care home experiencing a COVID-19 outbreak, or a home having asymptomatic cases.

FINDINGS

Over half of the care homes (53.2%, n=41), had laboratory-confirmed clinical cases and 39 (95.1%) of these were reported as outbreaks. A small number of care homes (10.4%, n=8) had asymptomatic cases and over a third had no clinical or asymptomatic cases (36.4%, n=28). There was no significant difference between the overall Care Quality Commission rating of Liverpool and English care homes (p=0.57). There was no significant association between any of the Care Quality Commission rating domains and the presence of COVID-19 outbreaks and/or asymptomatic cases.

CONCLUSIONS

During the first wave of the COVID-19 pandemic, Care Quality Commission ratings were not associated with COVID-19 outbreaks or asymptomatic cases in care homes. Infection prevention and control components of Care Quality Commission ratings need to be strengthened to identify care homes at a potential risk of infectious disease outbreaks that may require targeted support. Further large-scale studies will be required to test the findings from this study.

摘要

背景

在第一波疫情中,新冠病毒给养老院的人群带来了巨大的负担。英国国家医疗服务体系(NHS)的质量监管机构对所有英国养老院进行质量评级,这些评级可用于识别养老院是否有发生新冠疫情的风险。

方法

我们对利物浦的养老院进行了一次审计,以确定养老院的新冠疫情状况与英国国家医疗服务体系质量监管机构的评级之间是否存在关联。单变量逻辑回归用于确定养老院质量评级是否与养老院发生新冠疫情或出现无症状病例有关。

结果

超过一半的养老院(53.2%,n=41)出现了经实验室确诊的临床病例,其中 39 例(95.1%)被报告为疫情爆发。少数养老院(10.4%,n=8)出现了无症状病例,超过三分之一的养老院(36.4%,n=28)没有临床或无症状病例。利物浦和英国的养老院的英国国家医疗服务体系整体质量评级之间没有显著差异(p=0.57)。英国国家医疗服务体系质量监管机构评级的任何领域都与新冠疫情爆发和/或无症状病例之间没有显著关联。

结论

在新冠疫情的第一波疫情中,英国国家医疗服务体系质量评级与养老院的新冠疫情爆发或无症状病例无关。英国国家医疗服务体系质量监管机构评级的感染预防和控制部分需要加强,以识别可能存在传染病爆发风险的养老院,这可能需要提供有针对性的支持。需要进一步开展大规模研究来检验本研究的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c59a/7831635/000d4078636e/gr1_lrg.jpg

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