Excess mortality among older adults institutionalized in long-term care facilities during the COVID-19 pandemic: a population-based analysis in Catalonia

• DOI: 10.3389/fpubh.2023.1208184
• Publication Date: 2023-08-25T00:34:00Z
• Authors: Laia Cases; Emili Vela; Sebastià J. Santa...; Joan Carles Contel; Gerard Carot-Sans; Marc Coca; Marta Pastor; Ignasi Carrasco; Conxita Barbeta; Anna Vila; Paloma Amil; Aina Plaza; Caridad Pontes; Jordi Piera-Jiménez; Jordi Amblàs
• Keywords: Pandemic; Excess mortality

Objectives To assess excess mortality among older adults institutionalized in nursing homes within the successive waves of COVID-19 pandemic Catalonia (north-east Spain). Design Observational, retrospective analysis population-based central healthcare registries. Setting and participants Individuals aged >65 years admitted any home between January 1, 2015, April 2022. Methods Deaths reported during pre-pandemic period (2015–2019) were used to build a reference model for trends (a Poisson model, due event counting nature variable “mortality”), adjusted by age, sex, clinical complexity, defined according morbidity groups. Excess was estimated comparing observed model-based expected (2020–2022). Besides crude mortality, we standardized rate (SMR) as ratio weekly deaths’ number over same period. Results The included 175,497 (mean 262 days, SD 132), yielding total 394,134 person-years: 288,948 person-years 105,186 deaths this population 5,403 first wave 1,313, 111, −182, 498, 329 waves. on March 2020 showed highest SMR (2.50; 95% CI 2.45–2.56). corresponding 2nd 6th 1.31 (1.27–1.34), 1.03 (1.00–1.07), 0.93 (0.89–0.97), 1.13 (1.10–1.17), 1.07 (1.04–1.09). following ranged from 1,313 (2nd wave) −182 (4th wave). similar men women. Older those with higher comorbidity burden account deaths, albeit lower SMRs. Conclusion suggest death toll crisis than other settings. Although rates far at health risk, younger individuals persistently SMR, indicating an important these groups people.