Ingham Institute, SWSLHD, Liverpool, Sydney, NSW, 2170, Australia.
Biosecurity Research Program, The Kirby Institute, UNSW, Wallace Wurth Building, High St, Kensington Campus, Kensington, NSW, 2052, Australia.
BMC Geriatr. 2023 Aug 22;23(1):507. doi: 10.1186/s12877-023-04154-z.
Residential aged-care facilities in Australia emerged as the high-risk setting the COVID-19 outbreaks due to community transmission. The vulnerable aged-care residents of these facilities suffered due to low hospital transfers and high mortality and morbidity rates. This study aimed to monitor and report the burden of COVID-19 in residential aged-care facilities across Australia and the impact of hospital transfer policies on resident hospitalisation during the first year of the pandemic.
We conducted a retrospective cohort study by collecting data from weekly aged-care outbreak reports published by open sources and official government sources between 1st March and 20th November 2020. A comprehensive line list of outbreaks was created using open-source data. The line list included the name of the facility, location, COVID-19 cases among residents, & staff, resident hospitalisations, mode of transmission, number of resident deaths, and state policies involving resident hospitalisation. We also searched the websites of these facilities to collect data on their COVID-19 policies for the residents, staff, and visitors. Statistical analyses were performed on the data obtained.
126 aged-care COVID-19 outbreaks were identified in Australia during the study period. The incidence rate of COVID-19 infections among aged-care residents in Australia was (1118.5 per 100,000 resident population) which is 10 times higher than the general population (107.6 per 100,000 population). The hospitalisation rate for aged-care residents in Australia was 0.93 per 100,000 population. The hospitalisation rate of aged-care residents in Victoria was 3.14 per 100,000 population despite having the highest COVID-19 cases. Excluding South Australia, all states followed ad-hoc case-by-case hospital transfer policies for aged-care residents.
This study documented a higher risk of COVID-19 infection for aged-care residents and workers but found low hospitalisation rates among residents across Australia. The hospitalisation rates in Victoria were higher than the national average but low when considering the COVID-19 infection rates in the state. The hospitalisation rates could have been impacted due to the state hospital transfer policies at that time. Immediate transfer of infected residents to hospitals may improve their survival and reduce the risk of infection to the other residents, as healthcare settings have more advanced infection control measures and are well-equipped with trained staff and resources.
由于社区传播，澳大利亚的养老院成为 COVID-19 爆发的高风险场所。这些设施中的弱势老年居民由于低住院转移率和高死亡率和发病率而遭受痛苦。本研究旨在监测和报告澳大利亚各地养老院的 COVID-19 负担，以及大流行第一年医院转移政策对居民住院治疗的影响。
我们通过收集 2020 年 3 月 1 日至 11 月 20 日期间公开来源和官方政府来源发布的每周养老院疫情报告中的数据，进行了回顾性队列研究。使用开源数据创建了全面的疫情清单。该清单包括设施名称、位置、居民和员工中的 COVID-19 病例、居民住院治疗情况、传播途径、居民死亡人数以及涉及居民住院治疗的州政策。我们还搜索了这些设施的网站，以收集其针对居民、员工和访客的 COVID-19 政策数据。对获得的数据进行了统计分析。
在研究期间，澳大利亚共发现 126 起养老院 COVID-19 疫情。澳大利亚养老院居民 COVID-19 感染发病率为（每 10 万居民 1118.5 例），是普通人群（每 10 万人 107.6 例）的 10 倍。澳大利亚养老院居民的住院率为每 10 万人 0.93 例。尽管维多利亚州的 COVID-19 病例最多，但该州养老院居民的住院率为每 10 万人 3.14 例。除南澳大利亚州外，所有州对养老院居民都采取了临时逐案的住院转移政策。
本研究记录了养老院居民和工作人员感染 COVID-19 的风险较高，但发现澳大利亚各地养老院居民的住院率较低。维多利亚州的住院率高于全国平均水平，但考虑到该州的 COVID-19 感染率，住院率较低。住院率可能受到当时州医院转移政策的影响。立即将感染的居民转移到医院可能会提高他们的生存率并降低其他居民感染的风险，因为医疗机构具有更先进的感染控制措施，并且配备了训练有素的工作人员和资源。
