Health Affairs, volume 40, issue 4, pages 655-663
COVID-19 Mortality Rates Among Nursing Home Residents Declined From March To November 2020
Cyrus M. Kosar
1
,
Elizabeth M. White
2
,
Richard A. Feifer
3
,
Carolyn Blackman
4
,
Stefan Gravenstein
5
,
Orestis A. Panagiotou
6
,
Kevin McConeghy
7
,
Vincent Mor
8
3
Richard A. Feifer is the chief medical officer of Genesis Physician Services at Genesis HealthCare, in Kennett Square, Pennsylvania.
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4
Carolyn Blackman is the Northeast Region vice president for medical affairs of Genesis Physician Services at Genesis HealthCare.
6
Orestis A. Panagiotou is an assistant professor in the Department of Health Services, Policy, and Practice and the Center for Gerontology and Healthcare Research, Brown University School of Public Health.
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7
Kevin McConeghy is a doctoral student in the Department of Health Services, Policy, and Practice, Brown University School of Public Health.
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8
Vincent Mor is the Florence Pirce Grant University Professor in the Department of Health Services, Policy, and Practice and the Center for Gerontology and Healthcare Research, Brown University School of Public Health, and a research health scientist at the Providence Veterans Affairs Medical Center.
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Publication type: Journal Article
Publication date: 2021-03-11
Journal:
Health Affairs
scimago Q1
SJR: 4.387
CiteScore: 15.0
Impact factor: 8.6
ISSN: 02782715, 15445208
Health Policy
Abstract
Improved therapeutics and supportive care in hospitals have helped reduce mortality from COVID-19. However, there is limited evidence as to whether nursing home residents, who account for a disproportionate share of COVID-19 deaths and are often managed conservatively in the nursing home instead of being admitted to the hospital, have experienced similar mortality reductions. In this study we examined changes in thirty-day mortality rates between March and November 2020 among 12,271 nursing home residents with COVID-19. We found that adjusted mortality rates significantly declined from a high of 20.9 percent in early April to 11.2 percent in early November. Mortality risk declined for residents with both symptomatic and asymptomatic infections and for residents with both high and low clinical complexity. The mechanisms driving these trends are not entirely understood, but they may include improved clinical management within nursing homes, improved personal protective equipment supply and use, and genetic changes in the virus.
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