- Last updated: Thu, Jun 1, 2023Status: Published
- Read paper
- Ulrika Winblad, Wilhelm Linder, Douglas Spangler, and David Isaksson
Covid-19 in Swedish elderly care – the impact of health- and social care services on mortality in nursing homes
Nursing homes (NHs, SÄBO) and their residents were severely affected by the covid-19 pandemic with NH-residents (approximately 1% of the Swedish population) constituting approximately 40% of covid-19 related deaths. As the share of older individuals are increasing in Sweden, research on elderly care will be of uttermost importance in order to protect the elderly from future epi- and pandemics. This project relates to previous work by the Swedish Coronavirus Commission where data from SweCov was used to investigate covid-19 infections and mortality at Swedish NHs. Noticeably, two reports included in the preparatory documents from The Coronavirus Commission introduced a novel method for clustering individuals (and individual health data) to their respective NHs. In theory, structural factors of NHs (e.g. NH size) can affect both the covid-19 incidence and mortality (e.g. availability of nurses). Using this novel approach of selecting NH-residents using linked individual level data, Broms et al. reported that high NH staff turnover, lack of nurses, and larger NHs were associated with an increase in covid-19 infections and mortality.
To our knowledge, no previous study has investigated the impact of structural and process variables related to regional health care service use on patient related outcomes during the covid-19 pandemic for NH-residents. As such, there is a knowledge gap regarding to what extent health care services were able to prevent covid-19 morbidity and mortality in NH-residents and if the reported decline in services for elderly during the pandemic led to higher mortality (missed care).
Furthermore, previous work using this method has only studied the covid-19 pandemic and little is known regarding potential differences between NHs before, during, and after the pandemic. A longer time-series would allow us to investigate if health- and social care processes (and its impact on health-related outcomes, e.g. non-covid-19 mortality) changed during and after the pandemic. In summary, generating a study population with linked individual level data clustered on NHs through SweCov opens up many possibilities to investigate the impact of health- and social care on NH-residents before, during and after the covid-19 pandemic.