Preprint Article Version 2 Preserved in Portico This version is not peer-reviewed

Hospital Admissions From Care Homes in England During the COVID-19 Pandemic: A Retrospective, Cross-Sectional Analysis Using Linked Administrative Data

Version 1 : Received: 24 February 2021 / Approved: 25 February 2021 / Online: 25 February 2021 (17:16:08 CET)
Version 2 : Received: 24 May 2021 / Approved: 25 May 2021 / Online: 25 May 2021 (10:33:46 CEST)

A peer-reviewed article of this Preprint also exists.

Grimm, F., Hodgson, K., Brine, R. and Deeny, S. R. (2021) “Hospital admissions from care homes in England during the COVID-19 pandemic: a retrospective, cross-sectional analysis using linked administrative data”, International Journal of Population Data Science, 5(4). doi: 10.23889/ijpds.v5i4.1663. Grimm, F., Hodgson, K., Brine, R. and Deeny, S. R. (2021) “Hospital admissions from care homes in England during the COVID-19 pandemic: a retrospective, cross-sectional analysis using linked administrative data”, International Journal of Population Data Science, 5(4). doi: 10.23889/ijpds.v5i4.1663.

Journal reference: Int J Popul Data Sci 2021, 5
DOI: 10.23889/ijpds.v5i4.1663

Abstract

Background: Care home residents have complex healthcare needs but may have faced barriers to accessing hospital treatment during the first wave of the COVID-19 pandemic. Objective: To examine trends in the number of hospital admissions for care home residents during the first months of the COVID-19 outbreak. Methods: Retrospective analysis of a national linked dataset on hospital admissions for residential and nursing home residents in England (257,843 residents, 45% in nursing homes) between 20 January 2020 and 28 June 2020, compared to admissions during the corresponding period in 2019 (252,432 residents, 45% in nursing homes). Elective and emergency admission rates, normalised to the time spent in care homes across all residents, were derived across the first three months of the pandemic between 1 March and 31 May and primary admissions reasons for this period were compared across years. Results: Hospital admission rates rapidly declined during early March 2020 and remained substantially lower than in 2019 until the end of June. Between March and May, 2,960 admissions from residential homes (16.2%) and 3,295 admissions from nursing homes (23.7%) were for suspected or confirmed COVID-19. Rates of other emergency admissions decreased by 36% for residential and by 38% for nursing home residents (13,191 fewer admissions in total). Emergency admissions for acute coronary syndromes fell by 43% and 29% (105 fewer admission) and emergency admissions for stroke fell by 17% and 25% (128 fewer admissions) for residential and nursing home residents, respectively. Elective admission rates declined by 64% for residential and by 61% for nursing home residents (3,762 fewer admissions). Conclusions: This is the first study showing that care home residents’ hospital use declined during the first wave of COVID-19, potentially resulting in substantial unmet health need that will need to be addressed alongside ongoing pressures from COVID-19.

Supplementary and Associated Material

Keywords

Hospital admissions; care homes; COVID-19; linked data; administrative data

Comments (1)

Comment 1
Received: 25 May 2021
Commenter: Fiona Grimm
Commenter's Conflict of Interests: Author
Comment: Changes in the second version of this manuscript are mostly based on reviewers' comments and suggestion. This includes minor changes to the abstract, introduction and methods sections, additional analysis in the appendix and additional detail in existing tables, and additions to the discussion section. It also includes minor corrections to Tables 3 and S4.
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