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For-Profit LTC Home Status Tied to Extent of COVID-19 Outbreaks

In Canada, for-profit status tied to extent of outbreak, number of deaths, but not outbreak likelihood

nursing home

FRIDAY, July 24, 2020 (HealthDay News) -- For-profit status is associated with the extent of COVID-19 outbreaks in long-term care (LTC) homes, according to a study published online July 22 in CMAJ, the journal of the Canadian Medical Association.

Nathan M. Stall, M.D., from the University of Toronto, and colleagues conducted a retrospective cohort study of all 623 LTC homes (75,676 residents) in Ontario, Canada, from March 29 to May 20, 2020, using a COVID-19 outbreak database.

The researchers identified 190 outbreaks of COVID-19 in LTC homes, involving 5,218 residents. There were 1,452 deaths, with a 27.8 percent overall case fatality rate. There were associations seen for COVID-19 outbreaks with the incidence of COVID-19 in the public health unit region surrounding an LTC home, the number of residents, and older design standards of the home (adjusted odds ratios, 1.91, 1.38, and 1.55, respectively); no association was noted for profit status. Compared with nonprofit homes, for-profit status was associated with the extent of an outbreak in an LTC home and the number of resident deaths (adjusted risk ratios, 1.96 and 1.78, respectively). A higher prevalence of older design standards in for-profit homes and chain ownership mediated these associations.

"As health systems scramble to prepare LTC homes for successive waves of the COVID-19 pandemic and others search for accountability and solutions to the crisis in the sector, it is important to examine all potential explanations for observed differences in COVID19 outcomes across LTC homes," the authors write.

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