@article{Burton_J-2024_226775,
title = {Analysis of the impact of COVID-19 on Scotland's care-homes from March 2020 to October 2021: National linked data cohort analysis},
author = {Burton, J. and McMinn, M. and Vaughan, J. and Nightingale, G. and Fleuriot, J. and Guthrie, B.},
month = {feb},
year = {2024},
abstract = {Background: The impact of the COVID-19 pandemic on long-term care residents remains of wide interest, but most analyses focus on the initial wave of infections. Objective: To examine change over time in: (i) The size, duration, classification and pattern of care-home outbreaks of COVID-19 and associated mortality and (ii) characteristics associated with an outbreak. Design: Retrospective observational cohort study using routinely-collected data. Setting: All adult care-homes in Scotland (1,092 homes, 41,299 places). Methods: Analysis was undertaken at care-home level, over three periods. Period (P)1 01/03/2020-31/08/2020; P201/09/2020-31/05/2021 and P3 01/06/2021–31/10/2021. Outcomes were the presence and characteristics of outbreaks and mortality within the care-home. Cluster analysis was used to compare the pattern of outbreaks. Logistic regression examined care-home characteristics associated with outbreaks. Results: In total 296 (27.1%) care-homes had one outbreak, 220 (20.1%) had two, 91 (8.3%) had three, and 68 (6.2%) had four or more. There were 1,313 outbreaks involving residents: 431 outbreaks in P1, 559 in P2 and 323 in P3. The COVID-19 mortality rate per 1,000 beds fell from 45.8 in P1, to 29.3 in P2, and 3.5 in P3. Larger care-homes were much more likely to have an outbreak, but associations between size and outbreaks were weaker in later periods. Conclusions: COVID-19 mitigation measures appear to have been beneficial, although the impact on residents remained severe until early 2021. Care-home residents, staff, relatives and providers are critical groups for consideration and involvement in future pandemic planning.},
pages = {1-12},
volume = {53},
issue = {2},
journal = {Age and ageing},
publisher = {Oxford University Press},
url = {https://doi.org/10.1093/ageing/afae015},
}
