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- Title
Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review.
- Authors
Karimi-Dehkordi, Mehri; Hanson, Heather M.; Silvius, James; Wagg, Adrian
- Abstract
This study aimed to identify the individual, organizational, and environmental factors which contributed to COVID-19-related outcomes in long-term care facilities (LTCFs). A systematic review was conducted to summarize and synthesize empirical studies using a multi-level analysis approach to address the identified influential factors. Five databases were searched on 23 May 2023. To be included in the review, studies had to be published in peer-reviewed journals or as grey literature containing relevant statistical data. The Joanna Briggs Institute critical appraisal tool was employed to assess the methodological quality of each article included in this study. Of 2137 citations identified after exclusions, 99 records met the inclusion criteria. The predominant individual, organizational, and environmental factors that were most frequently found associated with the COVID-19 outbreak comprised older age, higher dependency level; lower staffing levels and lower star and subset domain ratings for the facility; and occupancy metrics and co-occurrences of outbreaks in counties and communities where the LTCFs were located, respectively. The primary individual, organizational, and environmental factors frequently linked to COVID-19-related deaths comprised age, and male sex; higher percentages of racial and ethnic minorities in LTCFs, as well as ownership types (including private, for-profit, and chain membership); and higher occupancy metrics and LTCF's size and bed capacity, respectively. Unfolding the risk factors collectively may mitigate the risk of outbreaks and pandemic-related mortality in LTCFs during future endemic and pandemics through developing and improving interventions that address those significant factors.
- Subjects
MORTALITY risk factors; RISK assessment; MEDICAL information storage &; retrieval systems; HOSPITAL utilization; PROPRIETARY health facilities; ECOLOGY; PROPRIETARY hospitals; HEALTH facility design &; construction; HEALTH status indicators; BODY mass index; INSURANCE; CINAHL database; SEX distribution; FRAIL elderly; SMOKING; HOSPITAL care; MEDICARE; AGE distribution; POLYPHARMACY; NURSING care facilities; SYSTEMATIC reviews; MEDLINE; RACE; WORKING hours; THEMATIC analysis; EPIDEMICS; MEDICAL databases; COGNITION disorders; NUTRITIONAL status; SOCIODEMOGRAPHIC factors; NURSING care facility administration; MINORITIES; HEALTH facilities; INFECTIOUS disease transmission; LENGTH of stay in hospitals; DEMENTIA; MEDICAL needs assessment; MEDICAID; COVID-19; COVID-19 pandemic; SOCIAL classes; COMORBIDITY; PSYCHOSOCIAL factors; DISEASE risk factors
- Publication
Healthcare (2227-9032), 2024, Vol 12, Issue 7, p807
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare12070807