Evidence map›Paper›PMID 39143027›Full record

ArticleJournal of the American Geriatrics Society2024

The extended impact of the COVID-19 pandemic on long-term care residents in Medicare with frailty or dual Medicaid enrollment.

Sunny C Lin, Jie Zheng, Arnold Epstein, E John Orav, Michael Barnett, David C Grabowski, Karen E Joynt Maddox

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

7 authors.

Sunny C LinDivision of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
Jie ZhengDepartment of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
Arnold EpsteinDepartment of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
E John OravDivision of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Michael BarnettDepartment of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
David C GrabowskiDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Karen E Joynt MaddoxCenter for Advancing Health Services, Policy & Economics Research, Institute of Public Health at Washington University, St. Louis, Missouri, USA.ORCID https://orcid.org/0000-0003-3779-8653

Funding

Improving the Quality of Care Provided Through Bundled Payments for Patients with Alzheimer's Disease or Other Forms of Dementia or FrailtyR01AG060935 · NIA · HARVARD SCHOOL OF PUBLIC HEALTH · PI EPSTEIN, ARNOLD, JOYNT MADDOX, KAREN ELLEN · 2019 to 2021
$2.7M
NIA NIH HHS R01 AG060935NIA NIH HHS R01 AG060935-01
6 · The paper itself

Abstract

backgroundAlthough many healthcare settings have since returned to pre-pandemic levels of operation, long-term care (LTC) facilities have experienced extended and significant changes to operations, including unprecedented levels of short staffing and facility closures, that may have a detrimental effect on resident outcomes. This study assessed the pandemic's extended effect on outcomes for LTC residents, comparing outcomes 1 and 2 years after the start of the pandemic to pre-pandemic times, with special focus on residents with frailty and dually enrolled in Medicare and Medicaid.

methodsUsing Medicare claims data from January 1, 2018, through December 31, 2022, we ran over-dispersed Poisson models to compare the monthly adjusted rates of emergency department use, hospitalization, and mortality among LTC residents, comparing residents with and without frailty and dually enrolled and non-dually enrolled residents.

resultsTwo years after the start of the pandemic, adjusted emergency department (ED) and hospitalization rates were lower and adjusted mortality rates were higher compared with pre-pandemic years for all examined subgroups. For example, compared with 2018-2019, 2022 ED visit rates for dually enrolled residents were 0.89 times lower, hospitalization rates were 0.87 times lower, and mortality rates were 1.17 higher; 2022 ED visit rates for frail residents were 0.85 times lower, hospitalization rates were 0.83 times lower, and mortality rates were 1.21 higher.

conclusionsIn 2022, emergency department and hospital utilization rates among long-term residents were lower than pre-pandemic levels and mortality rates were higher than pre-pandemic levels. These findings suggest that the pandemic has had an extended impact on outcomes for LTC residents.

Indexed as

COVID-19Emergency Service, HospitalHospitalizationLong-Term CareMedicaidMedicareSARS-CoV-2AgedAged, 80 and overFemaleFrail ElderlyFrailtyHomes for the AgedHumansMaleNursing HomesCOVID‐19dual‐Medicaid Medicare eligibilityfrail elderlylong‐term carepandemics

Identifiers

PMID39143027
PMCPMC11560535

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Registered trials

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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.