Nursing home quality, COVID-19 deaths, and excess mortality.
Nursing home quality, COVID-19 deaths, and excess mortality.
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DOI：
10.1016/j.jhealeco.2022.102592
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发表时间：
2022-03
影响因子：
3.5
通讯作者：
Evans WN
中科院分区：
文献类型：
--
作者：
Cronin CJ;Evans WN
美国新冠肺炎疫情对养老院居民造成的破坏尤为严重。一个关键的问题是，一些养老院如何能够有效地保护他们的居民，而另一些则没有？利用美国养老院的数据，我们检验了养老院的设立质量是否可以预测新冠肺炎的死亡率。根据CMS整体五星级评级衡量，质量更高的养老院到2020年9月的新冠肺炎死亡率显著较低。质量并不能预测预防新冠肺炎居民或工作人员感染病例的能力，但更高质量的机构只有在有病例的情况下才能防止居民感染的传播。预防新冠肺炎病例和死亡可能是要付出一些成本的，因为高质量的住房非CoVID死亡人数要高得多。医院质量与非冠状病毒死亡率之间的正相关性非常强，高质量的房屋的总死亡人数也比低质量的房屋多，而且这种关系随着时间的推移而增长。截至2021年4月下旬，五星级住宅的总死亡人数比一星级住宅高8.4%。
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.
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