Potenzielle Determinanten für COVID-19-Ausbrüche, Ausbruchsdauer, Verläufe und Sterbequoten in der stationären Altenpflege in Hessen in den ersten vier COVID-19-Wellen
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Philipps-Universität Marburg
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Abstract
Objective: This dissertation thoroughly investigates the determinants and effects of COVID-19 outbreaks in geriatric long-term care facilities in Hesse. Through an integrative analysis of data from three sub-studies, relationships between facility characteristics, staff qualifications, infection and mortality rates, and specific risks in private equity-managed nursing homes are highlighted.
Material: The study utilized data from various sources, including information from the Hessian Supervisory Authority for Care and Guardianship, the AOK Federal Association, and the Federal Statistical Office. The data includes detailed information on 687 geriatric long-term care facilities, covering the number of outbreaks, their duration, and infection rates among staff and residents, as well as their mortality, and the size, location, staffing and qualifications, co-payments, and profit orientation of the facilities.
Method: Retrospective cohort studies were conducted, applying various statistical methods, including logistic regressions, descriptive statistics, and t-tests.
Results: The analysis revealed that larger nursing homes significantly more often (+1.57, p = .009) and longer (+10.04 days, p > .001) recorded outbreaks of COVID-19. Another link was found between the proportion of certified nursing staff and the number and duration of outbreaks: a higher proportion of qualified staff was associated with a lower number of outbreaks (-0.1, p = .036) and a shorter duration (-6.02 days, p > .001). Furthermore, an association was measured between a higher proportion of single rooms and the outbreak duration (-4.5 days, p = .004) and the infection rates for residents (-5.3%, p < .001). In addition, infections among the residents (+24.26 days, p < .001) and staff (+22.98 days, p < .001) were linked to extended duration of outbreaks. Moreover, a larger proportion of infected staff (+12.8%, p < .001) and the profit orientation of the nursing homes (+5.1%, p < .001) were associated with an increased infection rate among the residents. Compared to other facilities, private equity-managed nursing homes showed a 5.38 times higher likelihood of infections and deaths (p < .05).
Discussion: The results highlight the central role of structural and staff characteristics in the prevention and control of COVID-19 outbreaks in geriatric long-term care facilities. In particular, the importance of certified nursing staff and single rooms in reducing the frequency and duration of outbreaks is emphasized. The significant correlations between facility size, infection rates, and ownership status underline the need for targeted measures and regulatory interventions.
Conclusions: For infection management in long-term care facilities, adapted structures and qualified staff are of great importance. Increased regulation and transparency, especially in private equity-managed facilities, are considered essential for improving care quality and protecting the residents and staff.
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Created: 2024Issued: 2025-02-12Updated: 2025-02-12
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
DFG-subjects
COVID-19 infections and deathStaff qualificationsPrivate-equity-owned nursing homesGeriatric long-term care facilitiesProportion of single ro
DDC-Numbers
610
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Evers, Janis (0000-0003-2244-2021): Potenzielle Determinanten für COVID-19-Ausbrüche, Ausbruchsdauer, Verläufe und Sterbequoten in der stationären Altenpflege in Hessen in den ersten vier COVID-19-Wellen. : Philipps-Universität Marburg 2025-02-12. DOI: https://doi.org/10.17192/z2024.0267.