Risk Factors Associated with Nursing Home COVID-19 Outbreaks: A Retrospective Cohort Study

Lucia Cazzoletti, Maria Elisabetta Zanolin, Ilaria Tocco Tussardi, Mulubirhan Assefa Alemayohu, Ernesto Zanetel, Donatella Visentin, Luca Fabbri, Massimo Giordani, Giancarlo Ruscitti, Pier Paolo Benetollo, Stefano Tardivo and Emanuele Torri
Additional contact information
Lucia Cazzoletti: Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Maria Elisabetta Zanolin: Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Ilaria Tocco Tussardi: Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Mulubirhan Assefa Alemayohu: Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Ernesto Zanetel: Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Donatella Visentin: Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Luca Fabbri: Azienda Provinciale per i Servizi Sanitari, Autonomous Province of Trento, 38123 Trento, Italy
Massimo Giordani: Unione Provinciale Istituzioni per l’Assistenza, Autonomous Province of Trento, 38122 Trento, Italy
Giancarlo Ruscitti: Department of Health and Social Policies, Autonomous Province of Trento, 38122 Trento, Italy
Pier Paolo Benetollo: Azienda Provinciale per i Servizi Sanitari, Autonomous Province of Trento, 38123 Trento, Italy
Stefano Tardivo: Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Emanuele Torri: Department of Health and Social Policies, Autonomous Province of Trento, 38122 Trento, Italy

IJERPH, 2021, vol. 18, issue 16, 1-17

Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic had a devastating impact on nursing homes/long-term care facilities. This study examined the relationship between geography, size, design, organizational characteristics, and implementation of infection prevention and control (IPC) measures and the extent of COVID-19 outbreaks in nursing homes in the Autonomous Province of Trento (Italy) during the time frame of March-May 2020. Methods: The analysis included 57 nursing homes (5145 beds). The association between median cumulative incidence of COVID-19 cases among residents and characteristics of nursing homes was assessed by Mann–Whitney U test, Kruskal–Wallis test or Spearman rho. To evaluate the potential confounding of geographical area, a 2-level random intercept logistic model was fitted, with level 1 units (patients in nursing homes) nested into level 2 units (nursing homes), and “being a COVID-19 case” as the dependent variable. Results: Median cumulative incidence was not significantly associated with any of the variables, except for geographical region ( p = 0.002). COVID-19 cases clustered in the part of the province bordering the Italian region most affected by the pandemic (Lombardy) (45.2% median cumulative incidence). Conclusions: Structural/organizational factors and standard IPC measures may not predict the epidemiology of COVID-19 outbreaks and be sufficient alone to protect nursing homes against them.

Keywords: COVID-19; epidemic risk; infection prevention and control; Italy; long-term care; nursing home; outbreak (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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