Evidence map›Paper›PMID 38995897›Full record

ArticlePloS one2024

Comparison of hospitalization events among residents of assisted living and nursing homes during COVID-19: Do settings respond differently during public health crises?

Colleen J Maxwell, Eric McArthur, David B Hogan, Hana Dampf, Jeffrey Poss, Joseph E Amuah, Susan E Bronskill, Erik Youngson, Zoe Hsu, Matthias Hoben

Abstract readComparative Study
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Colleen J MaxwellSchool of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada.ORCID 0000-0002-7988-2899
Eric McArthurLondon Health Sciences Centre, London, Ontario, Canada.
David B HoganDivision of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0002-9462-5460
Hana DampfFaculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
Jeffrey PossSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Joseph E AmuahSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Susan E BronskillICES, Toronto, Ontario, Canada.
Erik YoungsonProvincial Research Data Services, Alberta Health Services, Alberta, Canada.
Zoe HsuProvincial Research Data Services, Alberta Health Services, Alberta, Canada.
Matthias HobenFaculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0003-3465-315X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCOVID-19 and resulting health system and policy decisions led to significant changes in healthcare use by nursing homes (NH) residents. It is unclear whether healthcare outcomes were similarly affected among older adults in assisted living (AL). This study compared hospitalization events in AL and NHs during COVID-19 pandemic waves 1 through 4, relative to historical periods.

methodsThis was a population-based, repeated cross-sectional study using linked clinical and health administrative databases (January 2018 to December 2021) for residents of all publicly subsidized AL and NH settings in Alberta, Canada. Setting-specific monthly cohorts were derived for pandemic (starting March 1, 2020) and comparable historical (2018/2019 combined) periods. Monthly rates (per 100 person-days) of all-cause hospitalization, hospitalization with delayed discharge, and hospitalization with death were plotted and rate ratios (RR) estimated for period (pandemic wave vs historical comparison), setting (AL vs NH) and period-setting interactions, using Poisson regression with generalized estimating equations, adjusting for resident and home characteristics.

resultsOn March 1, 2020, there were 9,485 AL and 14,319 NH residents, comparable in age (mean 81 years), sex (>60% female) and dementia prevalence (58-62%). All-cause hospitalization rates declined in both settings during waves 1 (AL: adjusted RR 0.60, 95%CI 0.51-0.71; NH: 0.74, 0.64-0.85) and 4 (AL: 0.76, 0.66-0.88; NH: 0.65, 0.56-0.75) but unlike NHs, AL rates were not significantly lower during wave 2 (and increased 27% vs NH, January 2021). Hospitalization with delayed discharge increased in NHs only (during and immediately after wave 1). Both settings showed a significant increase in hospitalization with death in wave 2, this increase was larger and persisted longer for AL.

conclusionsPandemic-related changes in hospitalization events differed for AL and NH residents and by wave, suggesting unique system and setting factors driving healthcare use and outcomes in these settings in response to this external stress.

Indexed as

Assisted Living FacilitiesCOVID-19HospitalizationNursing HomesAgedAged, 80 and overAlbertaCross-Sectional StudiesFemaleHumansMalePandemicsPublic HealthSARS-CoV-2

Identifiers

PMID38995897
PMCPMC11244779

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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.