scholarly journals The Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes

Author(s):  
Alyssa B Dufour ◽  
Cyrus Kosar ◽  
Vincent Mor ◽  
Lewis A Lipsitz

Abstract Background Nursing home (NH) residents, especially those who were Black or with dementia, had the highest infection rates during the COVID-19 pandemic. A 9-week COVID-19 infection control intervention in 360 Massachusetts NHs showed adherence to an infection control checklist with proper personal protective equipment (PPE) use and cohorting was associated with declines in weekly infection rates. NHs were offered weekly webinars, answers to infection control questions, resources to acquire PPE, backup staff, and SARS-CoV-2 testing. We asked whether the effect of this intervention differed by racial and dementia composition of the NHs. Methods Data were obtained from 4 state audits using infection control checklists, weekly infection rates, and Minimum Data Set variables on race and dementia to determine whether adherence to checklist competencies was associated with decline in average weekly rates of new COVID-19 infections. Results Using a mixed-effects hurdle model, adjusted for county COVID-19 prevalence, we found the overall effect of the intervention did not differ by racial composition, but proper cohorting of residents was associated with a greater reduction in infection rates among facilities with ≥20% non-Whites (n = 83). Facilities in the middle (>50%–62%; n = 121) and upper (>62%; n = 115) tertiles of dementia prevalence had the largest reduction in infection rates as checklist scores improved. Cohorting was associated with greater reductions in infection rates among facilities in the middle and upper tertiles of dementia prevalence. Conclusions Adherence to proper infection control procedures, particularly cohorting of residents, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents (non-White and dementia).

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 730-730
Author(s):  
Alyssa Dufour ◽  
Cyrus Kosar ◽  
Vincent Mor ◽  
Lewis Lipsitz

Abstract Nursing home (NH) residents, especially those who were Black or had dementia, had the highest infection rates during the COVID-19 pandemic. A 9-week COVID-19 infection control intervention in 360 Massachusetts NHs showed that adherence to an infection control checklist with proper PPE use and cohorting, was associated with declines in weekly infection rates. NHs were offered weekly webinars, answers to infection control questions, resources to acquire personal protective equipment, backup staff, and SARS-CoV-2 testing. We asked whether the effect of this intervention differed by racial and dementia composition of the NHs. Data were obtained from 4 state audits using infection control checklists, weekly infection rates, and Minimum Data Set variables on race and dementia to determine whether adherence to the checklist competencies was associated with decline in average weekly rates of new COVID-19 infections. Using a mixed effects hurdle model, adjusted for county COVID-19 prevalence, we found that the overall effect of the intervention did not differ by race, but proper cohorting of residents was associated with a greater reduction in infection rates among facilities with ≥20% non-whites (n=83). Facilities in the middle (50-61%; n=116) and upper (>61%; n=118) tertiles of dementia prevalence had the largest reduction in infection rates as checklist scores improved. Cohorting was associated with greater reductions in infection rates among facilities in the middle and upper tertiles of dementia prevalence. Thus, adherence to proper infection control procedures, particularly cohorting, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents (non-white and dementia).


2013 ◽  
Vol 99 (4) ◽  
pp. 40-45 ◽  
Author(s):  
Aaron Young ◽  
Philip Davignon ◽  
Margaret B. Hansen ◽  
Mark A. Eggen

ABSTRACT Recent media coverage has focused on the supply of physicians in the United States, especially with the impact of a growing physician shortage and the Affordable Care Act. State medical boards and other entities maintain data on physician licensure and discipline, as well as some biographical data describing their physician populations. However, there are gaps of workforce information in these sources. The Federation of State Medical Boards' (FSMB) Census of Licensed Physicians and the AMA Masterfile, for example, offer valuable information, but they provide a limited picture of the physician workforce. Furthermore, they are unable to shed light on some of the nuances in physician availability, such as how much time physicians spend providing direct patient care. In response to these gaps, policymakers and regulators have in recent years discussed the creation of a physician minimum data set (MDS), which would be gathered periodically and would provide key physician workforce information. While proponents of an MDS believe it would provide benefits to a variety of stakeholders, an effort has not been attempted to determine whether state medical boards think it is important to collect physician workforce data and if they currently collect workforce information from licensed physicians. To learn more, the FSMB sent surveys to the executive directors at state medical boards to determine their perceptions of collecting workforce data and current practices regarding their collection of such data. The purpose of this article is to convey results from this effort. Survey findings indicate that the vast majority of boards view physician workforce information as valuable in the determination of health care needs within their state, and that various boards are already collecting some data elements. Analysis of the data confirms the potential benefits of a physician minimum data set (MDS) and why state medical boards are in a unique position to collect MDS information from physicians.


2018 ◽  
Vol 27 (4) ◽  
pp. 191-198
Author(s):  
Karen Van den Bussche ◽  
Sofie Verhaeghe ◽  
Ann Van Hecke ◽  
Dimitri Beeckman

Author(s):  
Cassandra L. Hua ◽  
Kali S. Thomas ◽  
Jennifer Bunker ◽  
Pedro L. Gozalo ◽  
Joan M. Teno

Author(s):  
Charles D. Phillips ◽  
Kathleen M. Spry

RÉSUMÉTrès peu de recherches ont été effectuées sur les pensionnaires des maisons de soins ayant manifestés des troubles mentaux chroniques sans démence avant leur entrée en institution. Les données du Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS) de 1993 ont été utilisées pouranalyser les différences dans les caractéristiques et les soins se rapportant à ce type de pensionnaires par rapport aux autres pensionnaires. Cette enquête portait sur 70 000 pensionnaires du Kansas, du Maine, du Mississippi et du Dakota du Sud. Les caractéristiques des pensionnaires qui éprouvaient ce type de troubles mentaux chroniques étaient plus fréquemment les suivantes: sexe masculin, 65 ans et plus, bénéficiaires de Medicaid, moins médicalement inaptes et niveau plus élevé de problèmes de comportements. Ces pensionnaires reçoivent aussi davantage de médicaments psychotropes et suivant une thérapie, la prévalence de la thérapie étant cependant moins éleveé. Les informations recueillies pourraient laisser croire que les soins accordés à ces pensionnaires ne sont pas des plus appropriés.


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