The relationship between person-centered care in nursing homes and COVID-19 infection, hospitalization, and mortality rates.
Meera Tandan, Migette L Kaup, Laci J Cornelison and 1 others
PMID 37028151WHAT IT FOUND
Kansas nursing homes in a person-centered care program had lower COVID-19 cases, admission/readmission, and mortality rates at the highest reported levels than non-program homes.
This association does not prove the program caused better infection control.
Key findings
01Above the 90th percentile, non-PEAK homes had 3.9 times more COVID-19 cases than PEAK homes: 31 cases per 1000 resident days versus 8 cases.
02Above the 95th percentile, non-PEAK homes had a COVID-19 mortality rate of 10.7 per 100 positive cases, compared with 0 in PEAK homes.
03PEAK includes 12 core person-centered practices, and the study does not allow a causal examination of their association with infection control.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is observational and cannot show that PEAK caused lower COVID-19 rates. PEAK participation was voluntary, and homes that adopt person-centered care may differ from non-PEAK homes, including by ownership, Medicaid mix, occupancy, and quality ratings. The analysis used nursing-home-level data, not individual resident data, and could not include covariates that were unavailable. It covered only Kansas nursing homes during January 20 to July 31, 2020, so it may not apply to other places or later pandemic phases. PEAK is a bundle of 12 core practices, so the study cannot identify which component was associated with the outcomes. The text says median rates and 75th percentile rates were 0 in all homes, while Table 2 lists non-PEAK medians of 0.09 for cases and admissions and 0.03 for mortality.
Declared interests
The work was supported by the Kansas State Center on Aging, Richardson Foundation Fund. One author is the Co-Principal Investigator on the PEAK Project contracted with the Kansas Department for Aging and Disability, and another is the PEAK Program Director. Other authors declare no conflict of interests.
The easy way to misread this
Do not conclude that person-centered care will reduce residents' COVID-19 infection, admission/readmission, or mortality. The study compared homes that chose to join PEAK with homes that did not, did not control for all differences, and states the design does not allow causal examination. PEAK also includes 12 core practices, so the study cannot separate which component, if any, mattered.