SynthesisJournal of the American Geriatrics Society2021
A systematic review of long-term care facility characteristics associated with COVID-19 outcomes.
Synthesis in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
78 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Epidemiology of COVID-19 outbreaks in aged care facilities during postvaccine period: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- A systematic review of long-term care facility characteristics associated with COVID-19 outcomes.Journal of the American Geriatrics Society · 2021Pooled it
- Pragmatic Implementation of a Music Intervention in Nursing Homes Before and During COVID-19.Journal of the American Medical Directors Association · 2024Trial
- How do interdisciplinary practitioners conceptualize infection control in nursing homes during the COVID-19 pandemic?International journal of qualitative studies on health and well-being · 2026Article
- Article
- Article
- Factors Associated With Mortality in Appalachian Nursing Homes During the COVID-19 Pandemic.The Permanente journal · 2026Article
- Characteristics of the Long-Term Care Data Cooperative: A New Resource for Research on Outcomes in Long-Term Care.Journal of the American Geriatrics Society · 2026Article
- Article
- Association Between State Essential Caregiver Programs and Antipsychotic Medication Use Rate in Nursing Homes During the COVID-19 Pandemic.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2026Article
- [Unequal impact of COVID-19 on mortality in long-term care homes across health areas of Castilla-La Mancha (Spain)].Anales del sistema sanitario de Navarra · 2026Article
- Ownership change in American nursing homes during the COVID-19 pandemic and the relationship with measures in Donabedian's model of care quality.The Gerontologist · 2026Article
- Internationally studied parameters related to the COVID-19 pandemic in nursing homes: a scoping review.Systematic reviews · 2026Article
- Demystifying Quality Metrics and Unveiling the True Measure of Quality of Care in Nursing Homes: Mixed Effects Analysis.JMIR human factors · 2026Article
- Exacerbation of racial disparities in COVID-19 outcomes by Alzheimer's disease and related dementias among nursing home residents.American journal of epidemiology · 2026Article
- Long term health related quality of life among individuals after COVID 19 recovery in a multicentric community based study.Scientific reports · 2025Article
- Variation in emergency department visits among residents of Swedish nursing homes between 2019 and 2020, a population-based cohort study.BMC health services research · 2025Article
- Lifting Federal Visitation Restriction and COVID-19 Infections in Nursing Homes.Journal of the American Medical Directors Association · 2025Article
- Overview of Systematic Reviews on Factors Related to the Structure and Functioning of Residential Long-Term Care Facilities for Older Adults.Geriatrics (Basel, Switzerland) · 2025Review
- Developing a framework for infection control education in nursing homes: Applying the mixed-methods Delphi technique.Journal of Korean gerontological nursing · 2025Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
BACKGROUND/
objectivesThe coronavirus disease 2019 (COVID-19) pandemic has taken a disproportionate toll on long-term care facility residents and staff. Our objective was to review the empirical evidence on facility characteristics associated with COVID-19 cases and deaths.
designSystematic review.
settingLong-term care facilities (nursing homes and assisted living communities).
participantsThirty-six empirical studies of factors associated with COVID-19 cases and deaths in long-term care facilities published between January 1, 2020 and June 15, 2021. MEASUREMENTS: Outcomes included the probability of at least one case or death (or other defined threshold); numbers of cases and deaths, measured variably.
resultsLarger, more rigorous studies were fairly consistent in their assessment of risk factors for COVID-19 outcomes in long-term care facilities. Larger bed size and location in an area with high COVID-19 prevalence were the strongest and most consistent predictors of facilities having more COVID-19 cases and deaths. Outcomes varied by facility racial composition, differences that were partially explained by facility size and community COVID-19 prevalence. More staff members were associated with a higher probability of any outbreak; however, in facilities with known cases, higher staffing was associated with fewer deaths. Other characteristics, such as Nursing Home Compare 5-star ratings, ownership, and prior infection control citations, did not have consistent associations with COVID-19 outcomes.
conclusionGiven the importance of community COVID-19 prevalence and facility size, studies that failed to control for these factors were likely confounded. Better control of community COVID-19 spread would have been critical for mitigating much of the morbidity and mortality long-term care residents and staff experienced during the pandemic. Traditional quality measures such as Nursing Home Compare 5-Star ratings and past deficiencies were not consistent indicators of pandemic preparedness, likely because COVID-19 presented a novel problem requiring extensive adaptation by both long-term care providers and policymakers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.