Article
Mortality of residents in long-term care facilities during the first wave of the pandemic: an insurance claims analysis on risk factors
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Authors
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Raphael Kohl
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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Kathrin Jürchott
- Wissenschaftliches Institut der AOK, Berlin, Deutschland
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Christian Hering
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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Annabell Gangnus
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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Paul Gellert
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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Adelheid Kuhlmey
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
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Antje Schwinger
- Wissenschaftliches Institut der AOK, Berlin, Deutschland
| Published: | September 27, 2021 |
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Outline
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Background and status of (inter)national research: During the coronavirus crisis, nursing homes became hotspots of the pandemic in Germany, associated with significant mortality rates among infected residents. In addition, containment measures may have worsened the provision of health care for residents of long-term care facilities.
Question and objective: The COVID-Heim project aims to examine the impact of the SARS-CoV-2 pandemic on the situation of residents of long-term care facilities. Health and long term care insurance claim data was used to examine the death rates and provision of health care within the first half of 2020.
Method or hypothesis: This study is part of COVID-Heim, a project that combines various data sources in order to draw lessons from the corona pandemic for structural developments in nursing homes. The analysis of insurance claims data of the health insurance company AOK with almost one million nursing home residents (age over 60 years) between January 2015 and June 2020 provides information about (excess) mortality and medical care.
Results: Mortality of residents in long-term care facilities have risen during the first lockdown period in Germany (March 01–June 30, 2020) and is associated with age and age-related morbidities. Simultaneously hospital admissions have decreased by a third compared to the previous years. Among the decreased treatments time-sensitive conditions such as hip fracture and stroke are observed.
Discussion: The SARS-CoV-2 pandemic has been tough on residents of nursing homes. Not only are they individually at higher risk, necessary contact between residents and staff as well as concentration in collective accommodation are key issues for the observed outbreaks. On the other hand measures seem to have impacted health-care provision in general. Leaving a very vulnerable group twofold at risk.
Practical implications: Conclusions for further infection control nursing homes will be concluded.
Appeal for practice (science and/or care) in one sentence: Health protection for vulnerable people in a pandemic cannot focus on containment measures alone but must take into account the secondary effects of these measures.
