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Racial and ethnic disparities in COVID-19 infections and deaths across U.S. nursing homes.


ABSTRACT: BACKGROUND/OBJECTIVES:To determine racial/ethnic disparities in weekly counts of new coronavirus disease 2019 (COVID-19) cases and deaths among nursing home residents or staff. DESIGN:Cross-sectional analysis of national nursing home COVID-19 reports linked to other data. Multivariable two-part models modeled disparities in count of cases or deaths and logistic regressions modeled disparities in self-reported shortages in staff and personal protective equipment (PPE), across nursing home groups with varying proportions of racial/ethnic minority residents, defined as low-, medium-, medium-high-, and high-proportion groups. SETTING:12,576 nursing homes nationally PARTICIPANTS: None. INTERVENTION:None. MEASUREMENTS:Numbers of incident COVID-19 confirmed cases among residents and staff, and incident COVID-19 related deaths among residents (primary outcomes); and nursing home reported shortages in staff and PPE (secondary outcomes). All outcomes were reported for the week of May 25, 2020. RESULTS:The number of weekly new COVID-19 confirmed cases among residents ranged from an average of 0.4 cases per facility (SD=2.5) for the low-proportion group (93.0% had zero new case) to 1.5 cases per facility (SD=6.3) for the high-proportion group (78.9% had zero new case). Multivariable regression estimated that compared to the low-proportion group, the likelihood of having at least one new resident case was 76% higher (odds ratio [OR]=1.76, 95% confidence interval [CI] 1.38-2.25, p=0.000) for the high-proportion group. Similar across-facility disparities were found for the weekly count of new COVID-19 deaths among residents (ranging from 0.1 deaths per facility [SD=1.1] for the low-proportion group to 0.4 deaths [SD=2.0] for the high-proportion group) and in the weekly count of new COVID-19 confirmed cases among staff (ranging from 0.3 cases [SD=1.4] to 1.3 cases [SD=4.4] per facility). No substantial disparities in self-reported shortages of staff or PPE were found. CONCLUSION:Nursing homes caring for disproportionately more racial/ethnic minority residents reported more weekly new COVID-19 confirmed cases and/or deaths. Immediate actions are needed to address these system-level disparities.

SUBMITTER: Li Y 

PROVIDER: S-EPMC7537079 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Racial and Ethnic Disparities in COVID-19 Infections and Deaths Across U.S. Nursing Homes.

Li Yue Y   Cen Xi X   Cai Xueya X   Temkin-Greener Helena H  

Journal of the American Geriatrics Society 20200928 11


<h4>Background/objectives</h4>To determine racial/ethnic disparities in weekly counts of new COVID-19 cases and deaths among nursing home residents or staff.<h4>Design</h4>Cross-sectional analysis of national nursing home COVID-19 reports linked to other data. Multivariable two-part models modeled disparities in count of cases or deaths, and logistic regressions modeled disparities in self-reported shortages in staff and personal protective equipment (PPE), across nursing home groups with varyin  ...[more]

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