评估养老院规模和护理模式对新冠病毒疾病病例及死亡率的影响。
Assessing the influence of nursing home size and care models on COVID-19 case and mortality rates.
作者信息
Young Yuchi, Liu Yichun, Shayya Ashley, Chiu Wan-Yu, Hsu Wanhsiang, O'Grady Thomas
机构信息
Associate Professor, Dept. of Health Policy, Management & Behavior, School of Public Health, New York State University at Albany, USA.
Bureau of Environmental and Occupational Epidemiology, Department of Health, NY, USA.
出版信息
Geriatr Nurs. 2024 Nov-Dec;60:21-27. doi: 10.1016/j.gerinurse.2024.07.039. Epub 2024 Aug 30.
INTRODUCTION
This study examines the impact of COVID-19 on older adults in traditional nursing homes, Green Houses (GHs), and Continuing Care Retirement Communities-Nursing Homes (CCRCNHs).
METHODS
COVID-19 cases and deaths from CMS and LTCFocus data across 11 states from 6/2020 to 9/2022 were used, and Poisson regressions to compare care settings while adjusting for covariates.
RESULTS
CCRCNH and GH residents were older (84.4 and 83.1 years) than those in traditional NHs (77.5 and 77.6 years, p < 0.0001), with more female and White individuals. COVID-19 risk was higher in CCRCNHs (RR 1.51, 95 % CI 1.10-2.07), large NHs (RR 1.57, 95 % CI 1.14-2.15), and highest in small NHs (RR 1.80, 95 % CI 1.32-2.47). Mortality rates across NH types showed no significant difference.
CONCLUSION
The study shows that smaller, person-centered GHs are more effective in controlling COVID-19 infection, suggesting a need to rethink care models to incorporating GH features for better outcomes. GEORGE2 07-AUG-2024 11:31.
引言
本研究考察了新冠疫情对传统养老院、绿屋（GHs）以及持续照料退休社区养老院（CCRCNHs）中老年人的影响。
方法
使用了2020年6月至2022年9月期间来自11个州的医疗保险与医疗补助服务中心（CMS）和长期照护焦点（LTCFocus）数据中的新冠病例及死亡数据，并采用泊松回归分析在调整协变量的同时比较不同照护环境。
结果
CCRCNH和GH的居民年龄（分别为84.4岁和83.1岁）高于传统养老院居民（分别为77.5岁和77.6岁，p < 0.0001），女性和白人个体更多。CCRCNHs中新冠风险更高（相对风险1.51，95%置信区间1.10 - 2.07），大型养老院中风险也较高（相对风险1.57，95%置信区间1.14 - 2.15），小型养老院中风险最高（相对风险1.80，95%置信区间1.32 - 2.47）。不同类型养老院的死亡率无显著差异。
结论
该研究表明，规模较小、以人为本的绿屋在控制新冠感染方面更有效，这表明需要重新思考照护模式，纳入绿屋的特点以取得更好的效果。2024年8月7日11:31 乔治
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