[Trends in place of death for nursing home residents in an urban district during the COVID-19 pandemic: An analysis of death registry data].

BACKGROUND

The nursing home is a common place of death; however, little is known about the place of death with respect to the people living there. Was there a difference in the frequencies of the places of death of nursing home residents in an urban district and in the individual facilities before and during the COVID-19 pandemic?

METHODS

Full survey of deaths by retrospective analysis of death registry data from the years 2018 to 2021.

RESULTS

Over the four-year period 14,598 people died, with 3,288 (22.5%) being residents of 31 different nursing homes. Over the reference period before the pandemic (March 1, 2018 to December 31, 2019) 1,485 nursing home residents died: 620 (41.8%) in hospital, 863 (58.1%) in a nursing home. During the pandemic period (March 1, 2020 to December 31, 2021) 1,475 death were registered: 574 (38.9%) in hospital and 891 (60.4%) in a nursing home. The mean age over the reference period was 86.5 years (±8,6; median 88.4; 47.9 to 106.2), in the pandemic period it was 86.7 years (±8,5; median 87.9; 43.7 to 111.7). Before the pandemic 1,006 deaths (67.7%) occurred in females, during the pandemic it was 969 (65.7%). The relative risk (RR) as a measure for the increase in the probabilty for an "in-hospital" death during the pandemic period was 0.94. In different facilities, the number of deaths per bed during the reference and the pandemic period varied between 0.26 and 0.98, and the RR from 0.48 to 1.61.

DISCUSSION

For all nursing home residents, the frequency of deaths was not increasing and no shift towards an "in-hospital" death was observed. Several nursing homes revealed substantial differences and opposing trends. The strength and the type of effects of facility-related circumstances remain unclear.