School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA.
J Am Med Dir Assoc. 2024 May;25(5):912-916.e3. doi: 10.1016/j.jamda.2024.03.009. Epub 2024 Apr 16.
Severe obesity in nursing home (NH) residents is associated with specialized care needs, limited mobility, and challenges in daily living. The COVID-19 pandemic strained NH resources and exacerbated staffing shortages. This study aimed to assess the ability of US NHs to accept and care for residents with severe obesity post-COVID, as well as associated NH factors.
Cross-sectional nationwide survey of NH administrators (2021-2022).
290 NHs from a national sample (n = 224) and a targeted sample in Massachusetts and New Jersey (n = 66).
A survey designed to assess how NHs approach admitting and caring for people with severe obesity before and after COVID was fielded from 2021 to 2022. Responses were linked to facility information from the Certification and Survey Provider Enhanced Reports, Minimum Data Set, Nursing Home Compare, Area Health Resources File, and US Diabetes Surveillance System. Multivariable logistic regression was used to assess the effect of organizational and survey response variables.
Of the 2503 surveys sent to US NHs, 1923 were sent to the national NH stratified sample, and 580 were sent to the MA/NJ sample. Overall, 12% (301 of 2503) of NHs surveyed responded. The response rates were similar between the 2 samples. Of 290 NHs with complete data, 34% reported being unlikely to accept residents with severe obesity after COVID-19, compared with 25% before the pandemic (P < .001). The main barriers to acceptance were staffing shortages and difficulties meeting equipment and space needs. NHs with higher proportions of Black residents were more likely to admit individuals with severe obesity.
The decline in acceptance of residents with severe obesity during and after COVID-19 highlights potential challenges that this population faces in accessing care. Our results also raise concerns that an intersection of disparities may exist in Black patients with severe obesity.
养老院（NH）居民的严重肥胖与特殊护理需求、活动受限以及日常生活挑战有关。COVID-19 大流行使 NH 资源紧张，并加剧了人员短缺问题。本研究旨在评估美国 NH 在 COVID 后接受和照顾严重肥胖居民的能力，以及相关的 NH 因素。
对 NH 管理员进行的全国性横断面调查（2021-2022 年）。
来自全国样本（n=224）和马萨诸塞州和新泽西州目标样本（n=66）的 290 家 NH。
从 2021 年至 2022 年，进行了一项调查，旨在评估 NH 在 COVID 之前和之后如何对待和照顾严重肥胖患者。根据认证和调查提供者增强报告、最低数据集、NH 比较、区域卫生资源文件和美国糖尿病监测系统，将回答与设施信息相关联。使用多变量逻辑回归来评估组织和调查响应变量的效果。
在发给美国 NH 的 2503 份调查中，有 1923 份发给了全国 NH 分层样本，580 份发给了 MA/NJ 样本。总体而言，2503 家 NH 中有 12%（301 家）做出了回应。两个样本的回应率相似。在 290 家 NH 中，有完整数据的 NH 中有 34%表示在 COVID-19 后不太可能接受严重肥胖的居民，而在大流行前这一比例为 25%（P<0.001）。接受的主要障碍是人员短缺和难以满足设备和空间需求。黑人群体比例较高的 NH 更有可能收治严重肥胖患者。
COVID-19 期间和之后对严重肥胖居民接受度的下降突出了这一人群在获得护理方面可能面临的潜在挑战。我们的研究结果还表明，严重肥胖的黑人患者可能存在交叉差异。
