Nursing home infection control strategies during the COVID-19 pandemic

被引:0
作者
Festa, Natalia [1 ,2 ,3 ,10 ]
Katz-Christy, Nina [3 ]
Weiss, Max [3 ]
Lisk, Rebecca [3 ]
Normand, Sharon-Lise [4 ]
Grabowski, David C. [5 ]
Newhouse, Joseph P. [5 ,6 ,7 ,8 ]
Hsu, John [3 ,5 ,9 ]
机构
[1] Yale Sch Med, Dept Internal Med, New Haven, CT USA
[2] Yale Univ, Natl Clinician Scholars Program, New Haven, CT USA
[3] Harvard Med Sch, Massachusetts Gen Hosp, Mongan Inst, Boston, MA USA
[4] Harvard TH Chan Sch Publ Hlth, Dept Biostat, Boston, MA USA
[5] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA
[6] Harvard Kennedy Sch, Cambridge, MA USA
[7] Natl Bur Econ Res, Cambridge, MA USA
[8] Harvard TH Chan Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA USA
[9] Harvard Med Sch, Massachusetts Gen Hosp, Dept Med, Boston, MA USA
[10] Yale Univ, Natl Clinician Scholars Program, 333 Cedar St,POB 208088, New Haven, CT 06510 USA
关键词
American Rescue Plan Act of 2021; COVID-19; nursing homes; older adults; strike teams; CARE;
D O I
10.1111/jgs.18402
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
BackgroundThe American Rescue Plan Act of 2021 awarded $500 million toward scaling "strike teams" to mitigate the impact of Coronavirus Disease 2019 (COVID-19) within nursing homes. The Massachusetts Nursing Facility Accountability and Support Package (NFASP) piloted one such model during the first weeks of the pandemic, providing nursing homes financial, administrative, and educational support. For a subset of nursing homes deemed high-risk, the state offered supplemental, in-person technical infection control support. MethodsUsing state death certificate data and federal nursing home occupancy data, we examined longitudinal all-cause mortality per 100,000 residents and changes in occupancy across NFASP participants and subgroups that varied in their receipt of the supplemental intervention. ResultsNursing home mortality peaked in the weeks preceding the NFASP, with a steeper increase among those receiving the supplemental intervention. There were contemporaneous declines in weekly occupancy. The potential for temporal confounding and differential selection across NFASP subgroups precluded estimation of causal effects of the intervention on mortality. ConclusionsWe offer policy and design suggestions for future strike team iterations that could inform the allocation of state and federal funding. We recommend expanded data collection infrastructure and, ideally, randomized assignment to intervention subgroups to support causal inference as strike team models are scaled under the direction of state and federal agencies.
引用
收藏
页码:2593 / 2600
页数:8
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