Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study
Objectives To understand which organisational–structural characteristics of nursing homes—also referred to as long-term care facilities (LTCFs)—and the preventative measures adopted in response to the pandemic are associated with the risk of a COVID-19 outbreak.Setting LTCFs in Lazio region in Italy...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e061784.full |
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| author | Leonardo Palombi Alessio Abbondanzieri Stefano Orlando Tuba Mazhari Gennaro Cerone Fausto Ciccacci Giuseppe Liotta Sandro Mancinelli Maria Cristina Marazzi |
| author_facet | Leonardo Palombi Alessio Abbondanzieri Stefano Orlando Tuba Mazhari Gennaro Cerone Fausto Ciccacci Giuseppe Liotta Sandro Mancinelli Maria Cristina Marazzi |
| author_sort | Leonardo Palombi |
| collection | DOAJ |
| description | Objectives To understand which organisational–structural characteristics of nursing homes—also referred to as long-term care facilities (LTCFs)—and the preventative measures adopted in response to the pandemic are associated with the risk of a COVID-19 outbreak.Setting LTCFs in Lazio region in Italy.Design The study adopts a case–control design.Participants We included 141 facilities and 100 provided information for the study. Cases were defined as facilities reporting a COVID-19 outbreak (two or more cases) in March–December 2020; controls were defined as LTCFs reporting one case or zero. The exposures include the structural–organisational characteristics of the LTCFs as reported by the facilities, preventative measures employed and relevant external factors.Results Twenty facilities reported an outbreak of COVID-19. In binary logistic regression models, facilities with more than 15 beds were five times more likely to experience an outbreak than facilities with less than 15 beds OR=5.60 (CI 1.61 to 25.12; p value 0.002); admitting new residents to facilities was associated with a substantially higher risk of an outbreak: 6.46 (CI 1.58 to 27.58, p value 0.004). In a multivariable analysis, facility size was the only variable that was significantly associated with a COVID-19 outbreak OR= 5.37 (CI 1.58 to 22.8; p value 0.012) for larger facilities (>15 beds) versus smaller (<15 beds). Other characteristics and measures were not associated with an outbreak.Conclusion There was evidence of a higher risk of COVID-19 in larger facilities and when new patients were admitted during the pandemic. All other structural–organisational characteristics and preventative measures were not associated with an outbreak. This finding calls into question existing policies, especially where there is a risk of harm to residents. One such example is the restriction of visitor access to facilities, resulting in the social isolation of residents. |
| format | Article |
| id | doaj-art-2ac562f75c0f4c9bb5f20833628a6dd0 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2ac562f75c0f4c9bb5f20833628a6dd02025-01-28T09:35:10ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2022-061784Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control studyLeonardo Palombi0Alessio Abbondanzieri1Stefano Orlando2Tuba Mazhari3Gennaro Cerone4Fausto Ciccacci5Giuseppe Liotta6Sandro Mancinelli7Maria Cristina Marazzi8Biomedicine and Prevention, Università degli Studi di Roma Tor Vergata Facoltà di Medicina e Chirurgia, Roma, Lazio, ItalyBiomedicine and Prevention, Università degli Studi di Roma Tor Vergata Facoltà di Medicina e Chirurgia, Roma, Lazio, ItalyDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, ItalySchool of Population Health & Environmental Sciences, King`s College London, London, UKDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, ItalyUnicamillus, Saint Camillus International University of Health Sciences, Rome, ItalyDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, ItalyDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, ItalyLibera Università Maria Santissima Assunta, Roma, Lazio, ItalyObjectives To understand which organisational–structural characteristics of nursing homes—also referred to as long-term care facilities (LTCFs)—and the preventative measures adopted in response to the pandemic are associated with the risk of a COVID-19 outbreak.Setting LTCFs in Lazio region in Italy.Design The study adopts a case–control design.Participants We included 141 facilities and 100 provided information for the study. Cases were defined as facilities reporting a COVID-19 outbreak (two or more cases) in March–December 2020; controls were defined as LTCFs reporting one case or zero. The exposures include the structural–organisational characteristics of the LTCFs as reported by the facilities, preventative measures employed and relevant external factors.Results Twenty facilities reported an outbreak of COVID-19. In binary logistic regression models, facilities with more than 15 beds were five times more likely to experience an outbreak than facilities with less than 15 beds OR=5.60 (CI 1.61 to 25.12; p value 0.002); admitting new residents to facilities was associated with a substantially higher risk of an outbreak: 6.46 (CI 1.58 to 27.58, p value 0.004). In a multivariable analysis, facility size was the only variable that was significantly associated with a COVID-19 outbreak OR= 5.37 (CI 1.58 to 22.8; p value 0.012) for larger facilities (>15 beds) versus smaller (<15 beds). Other characteristics and measures were not associated with an outbreak.Conclusion There was evidence of a higher risk of COVID-19 in larger facilities and when new patients were admitted during the pandemic. All other structural–organisational characteristics and preventative measures were not associated with an outbreak. This finding calls into question existing policies, especially where there is a risk of harm to residents. One such example is the restriction of visitor access to facilities, resulting in the social isolation of residents.https://bmjopen.bmj.com/content/12/6/e061784.full |
| spellingShingle | Leonardo Palombi Alessio Abbondanzieri Stefano Orlando Tuba Mazhari Gennaro Cerone Fausto Ciccacci Giuseppe Liotta Sandro Mancinelli Maria Cristina Marazzi Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study BMJ Open |
| title | Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study |
| title_full | Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study |
| title_fullStr | Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study |
| title_full_unstemmed | Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study |
| title_short | Characteristics of nursing homes and early preventive measures associated with risk of infection from COVID-19 in Lazio region, Italy: a retrospective case–control study |
| title_sort | characteristics of nursing homes and early preventive measures associated with risk of infection from covid 19 in lazio region italy a retrospective case control study |
| url | https://bmjopen.bmj.com/content/12/6/e061784.full |
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