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Risk Stratification of Nursing Homes to Plan COVID-19 Responses: A Case Study of Victoria, Australia

Published online by Cambridge University Press:  18 June 2021

Joseph E. Ibrahim Open the ORCID record for Joseph E. Ibrahim [Opens in a new window] ,
Yingtong Li Open the ORCID record for Yingtong Li [Opens in a new window] ,
Charlotte Brown ,
Grace McKee ,
Hagar Eren  and
Tony Pham
Joseph E. Ibrahim*
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
Yingtong Li
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
Charlotte Brown
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
Grace McKee
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
Hagar Eren
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
Tony Pham
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
*
Corresponding author: Joseph E. Ibrahim, Email: joseph.ibrahim@monash.edu
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Abstract

Objective:

Emergency management responses to coronavirus disease 2019 (COVID-19) in nursing homes lacked preparation and nuance; moving forward, responses must recognize nursing homes are not generic organizations or services, and individually appreciate each’s unique nature, strengths, and limitations. The objective of this study was to describe an approach to stratifying nursing homes according to risk for COVID-19 outbreak.

Methods:

Population-based cross-sectional study of all accredited nursing homes in Victoria (n = 766), accommodating 48,824 permanent residents. We examined each home’s facility structure, governance history, socio-economic status, proximity to high-risk industry, and proximity and size of local acute public hospital, stratified by location, size, and organizational structure.

Results:

Privately owned nursing homes tend to be larger and metropolitan-based, and publicly owned homes regionally based and smaller in size. The details reveal additional nuance, eg, privately owned metropolitan-based medium- to large-sized facilities tended to have more regulatory noncompliance, no board of governance, and fewer Chief Executive Officers with clinical background. In contrast, the smaller, publicly owned, remote facilities perform better on those same metrics.

Conclusions:

Nursing homes should not be regarded as generic entities, and there is significant underlying heterogeneity. Stratification of nursing homes according to risk level is a viable approach to informing more nuanced policy direction and resource allocation for emergency management responses.

Keywords

COVID-19risk managementnursing homes
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 6 , December 2022 , pp. 2569 - 2576
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health

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