Background
Methods
Institutional context
Data
Methods
Results
Descriptive statistics
Overall (nursing and residential homes combined) | Nursing homes | Residential homes | |
---|---|---|---|
Care homes | 15,524 | 4428 | 11,096 |
Average bed capacity | 29.3 | 50.6 | 20.9 |
Total bed capacity offered | 455,594 | 223,917 | 231,677 |
Care home size | |||
Small homes [0–23 beds] | 49.2% | 12.0% | 64.1% |
Medium homes [24–40 beds] | 24.4% | 27.8% | 23.0% |
Large homes [41+ beds] | 26.4% | 60.2% | 12.9% |
Service type | |||
Providing services to older people and/or people with dementia | 71.7% | 93.4% | 63.1% |
Providing non-dementia services to children and/or adults only | 28.3% | 6.6% | 36.9% |
Provider type | |||
Branded (chain ownership) | 37.7% | 45.8% | 34.5% |
Non-branded (independent ownership) | 62.3% | 54.2% | 65.5% |
Legal status | |||
For-profit | 85.3% | 90.5% | 83.3% |
Not-for-profit | 14.7% | 9.5% | 16.7% |
% care homes reporting any death in the COVID-19 period | 59.7% | 89.0% | 47.9% |
% care homes reporting confirmed/suspected COVID-19 fatalities | 27.4% | 54.2% | 16.7% |
Observed, expected and excess deaths
Overall (nursing and residential homes combined) | Nursing homes | Residential homes | |
---|---|---|---|
Panel a. Total excess deaths | |||
Overall excess death | 29,542 [25,176; 33,908] | 18,891 [15,956; 21,826] | 10,651 [8914; 12,388] |
% excess deaths attributable to COVID-19 | 64.7 [56.41; 75.98] | 67.1 [58.11; 79.49] | 60.5 [52.03; 72.30] |
Reporting COVID-19 deaths | 29,429 [25,047; 33,810] | 19,722 [16,665; 22,778] | 9707 [8011; 11,403] |
Not reported | 112 [−457; 682] | − 831 [− 1291; −371] | 943 [503; 1383] |
Providing services to older people/with dementia | 28,958 [24,673; 33,242] | 18,786 [15,858; 21,714] | 10,171 [8470; 11,873] |
Providing non-dementia services to children and/or adults only | 584 [380; 789] | 105 [44; 166] | 479 [292; 666] |
For-profit care homes | 25,468 [21,685; 29,251] | 17,335 [14,782; 19,888] | 8133 [6592; 9674] |
Not-for-profit care homes | 4074 [3081; 5067] | 1556 [858; 2255] | 2517 [2005; 3030] |
Branded care homes | 14,671 [12,053; 17,288] | 9776 [8017; 11,534] | 4895 [3829; 5962] |
Non-branded care homes | 14,871 [12,702; 17,041] | 9116 [7540; 10,692] | 5755 [4864; 6647] |
Small homes [0–23 beds] | 1752 [1410; 2095] | 195 [55; 335] | 1558 [1231; 1885] |
Medium homes [24–40 beds] | 5751 [4791; 6711] | 2480 [1869; 3092] | 3270 [2770; 3771] |
Large homes [41+ beds] | 22,039 [18,564; 25,513] | 16,216 [13,704; 18,729] | 5823 [4524; 7122] |
Panel b. Total excess deaths per bed (in %, adjusted for bed capacity as reported in March 2020) | |||
Overall excess | 6.5 [5.5; 7.4] | 8.4 [7.1; 9.7] | 4.6 [3.8; 5.3] |
Overall excess attributable to COVID-19 | 4.2 [3.1; 5.7] | 5.7 [4.1; 7.7] | 2.8 [2.0; 3.9] |
Reporting COVID-19 deaths | 13.5 [11.5; 15.5] | 13.8 [11.7; 15.9] | 13.0 [10.7; 15.2] |
Not reported | 0.0 [−0.2; 0.3] | −1.0 [−1.6; −0.5] | 0.6 [0.3; 0.9] |
Providing services to older people/with dementia | 7.0 [5.9; 8.0] | 8.6 [7.3; 9.9] | 5.1 [4.3; 6.0] |
Providing non-dementia services to children and/or adults only | 1.5 [1.0; 2.0] | 1.9 [0.8; 3.0] | 1.4 [0.9; 2.0] |
For-profit care homes | 6.3 [5.4; 7.2] | 8.4 [7.2; 9.7] | 4.1 [3.3; 4.9] |
Not-for-profit care homes | 8.0 [6.1; 10.0] | 8.7 [4.8; 12.6] | 7.7 [6.1; 9.2] |
Branded care homes | 7.2 [6.0; 8.5] | 8.4 [6.9; 10.0] | 5.6 [4.4; 6.9] |
Non-branded care homes | 5.8 [5.0; 6.7] | 8.4 [7.0; 9.9] | 4.0 [3.4; 4.6] |
Small homes [0–23 beds] | 2.2 [1.8; 2.7] | 2.6 [0.7; 4.5] | 2.2 [1.7; 2.6] |
Medium homes [24–40 beds] | 4.7 [4.0; 5.5] | 6.0 [4.6; 7.5] | 4.1 [3.5; 4.7] |
Large homes [41+ beds] | 8.6 [7.3; 10.0] | 9.2 [7.8; 10.7] | 7.3 [5.6; 8.9] |
Care home characteristics associated with odds of one COVID-19 death
% of care homes in each category reporting COVID-19 deaths | Unadjusted OR (95% CI) | Multivariable adjusted OR (95% CI) | |||||
---|---|---|---|---|---|---|---|
OR | 95% CI | p value | OR | 95% CI | p value | ||
Overall (nursing and residential combined) | |||||||
Providing residential services only | 14.9 | 1 | (Reference) | 1 | (Reference) | ||
Providing nursing services | 20.0 | 5.93 | (5.47–6.42) | < 0.001 | 1.81 | (1.64–1.99) | < 0.001 |
Providing non-dementia services to children and/or adults only | 19.2 | 1 | (Reference) | 1 | (Reference) | ||
Providing services to older people/with dementia | 17.0 | 26.87 | (21.95–32.88) | < 0.001 | 5.45 | (4.36–6.81) | < 0.001 |
For-profit care homes | 16.6 | 1 | (Reference) | 1 | (Reference) | ||
Not-for-profit care home | 21.2 | 0.54 | (0.48–0.61) | < 0.001 | 0.96 | (0.83–1.11) | 0.605 |
Non-branded care homes | 14.4 | 1 | (Reference) | 1 | (Reference) | ||
Branded care homes | 21.7 | 1.6 | (1.48–1.72) | < 0.001 | 1.21 | (1.1–1.34) | < 0.001 |
Small homes [0–23 beds] | 11.4 | 1 | (Reference) | 1 | (Reference) | ||
Medium homes [24–40 beds] | 14.7 | 10.84 | (9.53–12.33) | < 0.001 | 5.2 | (4.52–5.98) | < 0.001 |
Large homes [41+ beds] | 21.9 | 35.69 | (31.43–40.52) | < 0.001 | 13.27 | (11.45–15.37) | < 0.001 |
Nursing | |||||||
Providing non-dementia services to children and/or adults only | 22.7 | 1 | (Reference) | 1 | (Reference) | ||
Providing services to older people/with dementia | 20.0 | 9.99 | (6.93–14.42) | < 0.001 | 2.98 | (1.98–4.49) | < 0.001 |
For-profit care homes | 19.6 | 1 | (Reference) | 1 | (Reference) | ||
Not-for-profit care home | 24.8 | 0.59 | (0.47–0.73) | < 0.001 | 0.91 | (0.71–1.17) | 0.48 |
Non-branded care homes | 17.4 | 1 | (Reference) | 1 | (Reference) | ||
Branded care homes | 23.1 | 1.61 | (1.42–1.83) | < 0.001 | 1.26 | (1.1–1.45) | 0.001 |
Small homes [0–23 beds] | 14.5 | 1 | (Reference) | 1 | (Reference) | ||
Medium homes [24–40 beds] | 16.3 | 5.97 | (4.43–8.03) | < 0.001 | 4.39 | (3.21–5.99) | < 0.001 |
Large homes [41+ beds] | 22.1 | 16.10 | (12.1–21.43) | < 0.001 | 10.88 | (8.03–14.74) | < 0.001 |
Residential | |||||||
Providing non-dementia services to children and/or adults only | 18.2 | 1 | (Reference) | 1 | (Reference) | ||
Providing services to older people/with dementia | 14.7 | 21.8 | (16.97–28) | < 0.001 | 6.57 | (5–8.63) | < 0.001 |
For-profit care homes | 14.3 | 1 | (Reference) | 1 | (Reference) | ||
Not-for-profit care home | 19.5 | 0.73 | (0.63–0.85) | < 0.001 | 0.99 | (0.83–1.19) | 0.943 |
Non-branded care homes | 12.8 | 1 | (Reference) | 1 | (Reference) | ||
Branded care homes | 20.2 | 1.31 | (1.17–1.46) | < 0.001 | 1.16 | (1.02–1.33) | 0.028 |
Small homes [0–23 beds] | 10.9 | 1 | (Reference) | 1 | (Reference) | ||
Medium homes [24–40 beds] | 14.0 | 9.70 | (8.34–11.27) | < 0.001 | 5.12 | (4.36–6.00) | < 0.001 |
Large homes [41+ beds] | 21.5 | 27.50 | (23.35–32.40) | < 0.001 | 13.45 | (11.26–16.08) | < 0.001 |