COVID-19 outcomes among people with intellectual and developmental disability in California: The importance of type of residence and skilled nursing care needs.
Scott D Landes, Margaret A Turk, Ashlyn W W A Wong
PMID 33309535WHAT IT FOUND
Most people with IDD receiving services in California lived in family homes and had the lowest case and death rates.
Skilled nursing facilities had the highest.
Key findings
01Among 354,640 Californians receiving IDD services, 89% lived in their own or a family home; this group had the least severe outcomes, with 523 cases per 100,000, a 2.8% case-fatality rate, and 15 deaths per 100,000.
02Californians receiving IDD services had 831 cases per 100,000, a 5.5% case-fatality rate, and 46 deaths per 100,000, compared with 2085 cases per 100,000, 1.9% case-fatality, and 41 deaths per 100,000 for Californians not receiving IDD services; their case rate was 60% lower, case-fatality rate was 2.8 times higher, and mortality rate was 1.1 times higher but not statistically significant.
03Case rates were highest in settings with more residents, at 19,031 per 100,000 in ICF-DD and 27,546 per 100,000 in SNF; case-fatality rates were highest in settings providing 24-h skilled nursing, at 15.8% in ICF/DD-N and 20.4% in SNF; SNF had the highest mortality rate at 5626 per 100,000.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study could not adjust for age within each residence type, and people in congregate settings may differ in age from those in family homes. It did not have detailed information on health conditions, medications, or personal and skilled nursing needs for people living in family homes. Skilled nursing care availability was used as a proxy for health care needs, and the study could not separate residence type from age or pre-existing conditions. It used a California dataset, so patterns may not apply to other states. Some differences between settings were not statistically significant.
Declared interests
No specific grant funding; authors report no conflict of interest.
The easy way to misread this
Do not conclude that living in a skilled nursing facility caused worse outcomes. The study did not control for age or existing health conditions, and people in these settings may have been older or sicker.