For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
Inviting an author to review:
Dynamic robotic tracking of underwater targets using reinforcement learning
Find an author and click ‘Invite to review selected article’ near their name.
Search for authorsSearch for similar articles
2
views
29
references
 Top references
cited by
10
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      181
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: not found

      Nursing Home Quality, COVID-19 Deaths, and Excess Mortality

      research-article
      Author(s): 1 , 2 , *
      Publication date (Electronic):
      Journal: Journal of Health Economics
      Publisher: Published by Elsevier B.V.

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The COVID-19 pandemic in the US has been particularly devastating for nursing home residents. A key question is how have some nursing homes been able to effectively protect their residents, while others have not? Using data on the universe of US nursing homes, we examine whether establishment quality is predictive of COVID-19 mortality. Higher-quality nursing homes, as measured by CMS overall five-star rating, have substantially lower COVID-19 mortality through September of 2020. Quality does not predict the ability to prevent any COVID-19 resident or staff cases, but higher-quality establishments prevent the spread of resident infections conditional on having one. Preventing COVID-19 cases and deaths may come at some cost, as high-quality homes have substantially higher non-COVID deaths. The positive correlation between establishment quality and non-COVID mortality is strong enough that high-quality homes also have more total deaths than their low-quality counterparts and this relationship has grown with time. As of late April 2021, five-star homes have experienced 8.4 percent more total deaths than one-star homes.

          Related collections

          Most cited references29

          • Record: found
          • Abstract: found
          • Article: not found

          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Fei Zhou, Ting Yu, Ronghui Du … (2020)
          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
          Article 0 comments Cited 13513 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found

            Characteristics of U.S. Nursing Homes with COVID ‐19 Cases

            Hannah R Abrams, Lacey Loomer, Ashvin Gandhi … (2020)
            Abstract Background COVID‐19 has been documented in a large share of nursing homes throughout the United States. This has led to high rates of mortality for residents. In order to understand how to prevent and mitigate future outbreaks, it is imperative that we understand which nursing homes are more likely to experience COVID‐19 cases. Objective To examine the characteristics of nursing homes with documented COVID‐19 cases in 30 states reporting individual facilities affected. Design and setting We constructed a database of nursing homes with verified COVID‐19 cases as of May 11, 2020 via correspondence with and publicly available reports from state departments of health. We linked this information to nursing home characteristics and used regression analysis to examine association between these characteristics and the likelihood of having a documented COVID‐19 case. Results Of 9,395 nursing homes in our sample, 2,949 (31.4%) had a documented COVID‐19 case. Larger facility size, urban location, greater percentage of African American residents, non‐chain status, and state were significantly (p<0.05) related to increased probability of having a COVID‐19 case. Five‐star rating, prior infection violation, Medicaid dependency, and ownership were not significantly related. Conclusions COVID‐19 cases in nursing homes are related to facility location and size and not traditional quality metrics such as star rating and prior infection control citations. This article is protected by copyright. All rights reserved.
            Article 0 comments Cited 136 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found

              COVID ‐19 infections and deaths among Connecticut nursing home residents: facility correlates

              Yue Li, Helena Temkin-Greener, Shan Gao … (2020)
              Abstract Objective To determine the associations of nursing home registered nurse (RN) staffing, overall quality of care, and concentration of Medicaid or racial and ethnic minority residents with COVID‐19 confirmed cases and deaths by April 16, 2020 among Connecticut nursing home residents. Design Cross‐sectional analysis on Connecticut nursing home (n=215) COVID‐19 report, linked to other nursing home files and county counts of confirmed cases and deaths. Multivariable two‐part models determined the associations of key nursing home characteristics with the likelihood of at least 1 confirmed case (or death) in the facility, and with the count of cases (deaths) among facilities with at least 1 confirmed case (death). Results The average number of confirmed cases was 8 per nursing home (zero in 107 facilities), and the average number of confirmed deaths was 1.7 per nursing home (zero in 131 facilities). Among facilities with at least 1 confirmed case, every 20 minutes (per resident day) increase in RN staffing was associated with 22% fewer confirmed cases (incidence rate ratio [IRR]=0.78, 95% confidence interval [CI] 0.68‐0.89, p<0.001); compared to 1‐ to 3‐star facilities, 4‐ or 5‐star facilities had 13% fewer confirmed cases (IRR=0.87, 95% CI 0.78‐0.97, p<0.015); and facilities with high concentration of Medicaid residents (IRR=1.16, 95% CI 1.02‐1.32, p=0.025) or racial/ethnic minority residents (IRR=1.15, 95% CI 1.03‐1.29, p=0.026) had 16% and 15% more confirmed cases, respectively, than their counterparts. Among facilities with at least 1 death, every 20 minutes increase in RN staffing significantly predicted 26% fewer COVID‐19 deaths (IRR=0.74, 95% CI 0.55‐1.00, p=0.047). Other focused characteristics did not show statistically significant associations with deaths. Conclusions Nursing homes with higher RN staffing and quality ratings have the potential to better control the spread of the novel coronavirus and reduce deaths. Nursing homes caring predominantly for Medicaid or racial and ethnic minority residents tend to have more confirmed cases.
              Article 0 comments Cited 84 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): J Health Econ
                Journal ID (iso-abbrev): J Health Econ
                Title: Journal of Health Economics
                Publisher: Published by Elsevier B.V.
                ISSN (Print): 0167-6296
                ISSN (Electronic): 1879-1646
                Publication date PMC-release: 21 January 2022
                Publication date (Electronic): 21 January 2022
                Electronic Location Identifier: 102592
                Affiliations
                [1 ]University of Notre Dame
                [2 ]University of Notre Dame, NBER and J-PAL
                Author notes
                [* ]Corresponding author: Professor William N Evans, University of Notre Dame, 51766 ashton ct, granger, IN 46530, United States
                Article
                Publisher Item ID: S0167-6296(22)00012-1 Publisher ID: 102592
                DOI: 10.1016/j.jhealeco.2022.102592
                PMC ID: 8776351
                PubMed ID: 35104669
                SO-VID: 8762e66a-9350-4397-b72a-aa06ff635f0f
                Copyright © © 2022 Published by Elsevier B.V.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 15 March 2021
                Date revision received : 10 January 2022
                Date accepted : 18 January 2022
                Categories
                Subject: Article

                ScienceOpen disciplines: Economics of health & social care
                Data availability:
                ScienceOpen disciplines: Economics of health & social care

                Comments

                Comment on this article

                scite_

                Similar content181

                See all similar

                Cited by10

                See all cited by

                Most referenced authors369

                See all reference authors