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

Grimm, Fiona; Hodgson, Karen; Brine, Richard; Deeny, Sarah R

doi:10.20944/preprints202102.0593.v1

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…Access to health care Between March and May 2020, emergency hospital admissions from care homes for conditions other than COVID-19 (including stroke and heart attack) decreased by 36%. 165 Routine elective admissions for care home residents (including care such as cataract surgery, some cancer treatment and hip replacements) fell by 63%. 165 Compared with the 56% reduction in routine admissions for the general population, this suggests that people living in care homes -who often have complex health needs and require high levels of hospital carewere particularly hard hit by reduced services with implications for their quality of life.…”

Section: Wider Health Impactsmentioning

confidence: 99%

Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report

Suleman¹,

Sonthalia²,

Webb³

et al. 2021

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Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report 2 48 5. The experiences of some groups disproportionately affected by the pandemic Some groups have faced disproportionate hardship and poorer health outcomes than others. This section looks at how the pandemic has affected the lives of four groups: care home residents, disabled people, ethnic minority communities and young people. 6. Public perceptions of COVID-19 and health inequalitiesTo inform this inquiry, the Health Foundation worked with consulting company Kantar Public to explore public attitudes to, and experiences of, health inequalities and the pandemic. 7. Recovery: risks and opportunitiesThe pandemic risks casting a long shadow over the nation's future health. This section highlights the main risks and how these might be mitigated. 8. ConclusionsThe conclusions of the inquiry point to the need for action in two main areas. First, immediate action to address the harm caused by the pandemic. Second, supporting longer term change to prevent future deterioration of health. References 79Acknowledgements 91 * Excess deaths measure additional deaths over a time period compared with the number of deaths usually expected. We measure the deaths caused by the pandemic in excess deaths instead of registered COVID-19 deaths due to discrepancies in the way COVID-19 deaths are recorded.Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report 5 Changes to the determinants of health 4 * This information was provided by Nadine Smith who conducted interviews with workers at Changing Lives charity as part of research commissioned by the Health Foundation.

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Section: Wider Health Impactsmentioning

confidence: 99%

Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report

Suleman¹,

Sonthalia²,

Webb³

et al. 2021

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“…However, the cluster assignments for all of the sequences of care before and after COVID-19 tests and positive COVID-19 tests contain a substantial specific inpatient cluster. There was still a group of residents in hospital, despite the decrease in secondary care use for care home residents at the start of the pandemic 20 .…”

Section: Discussionmentioning

confidence: 99%

Understanding Health Service Utilisation Patterns for Care Home Residents During the COVID-19 Pandemic using Routinely Collected Healthcare Data

Garner

Preston

Caiado

et al. 2023

Preprint

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Background Healthcare in care homes during the COVID-19 pandemic required a balance, providing treatment while minimising exposure risk. Policy for how residents should receive care changed rapidly throughout the pandemic. A lack of accessible data on care home residents over this time meant policy decisions were difficult to make and verify. This study investigates common patterns of healthcare utilisation for care home residents in relation to COVID-19 testing events, and associations between utilisation patterns and resident characteristics. Methods Linked datasets including secondary care, community care and a care home telehealth app are used to define daily healthcare utilisation sequences for care home residents. We derive four 10-day sets of sequences related to Pillar 1 COVID-19 testing; before [1] and after [2] a resident's first positive test and before [3] and after [4] a resident's first test. These sequences are clustered, grouping residents with similar healthcare patterns in each set. Association of individual characteristics (e.g. health conditions such as diabetes and dementia) with healthcare patterns are investigated. Results We demonstrate how routinely collected health data can be used to produce longitudinal descriptions of patient care. Clustered sequences [1,2,3,4] are produced for 3,471 care home residents tested between 01/03/2020-01/09/2021. Clusters characterised by higher levels of utilisation were significantly associated with higher prevalence of diabetes. Dementia is associated with higher levels of care after a testing event, and appears to be correlated with a hospital discharge after a first test. Residents discharged from inpatient care within 10 days of their first test had the same mortality rate as those who stayed in hospital. Conclusion We provide longitudinal, resident-level data on care home resident healthcare during the COVID-19 pandemic. We find that vulnerable residents were associated with higher levels of healthcare usage despite the additional risks. Implications of findings are limited by the challenges of routinely collected data. However, this study demonstrates the potential for further research into healthcare pathways using linked, routinely collected datasets.

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“…However, no research has looked at the financial feasibility of their employment by health systems. Over the past several decades, there has been a provider shortage in physician specialties, which was greatly exacerbated by the pandemic [ 7 ]. The rates of locum tenens usage by healthcare organizations (HCOs) had been increasing leading up to the pandemic, and now over 85% of HCOs utilize locum tenens in some capacity [ 8 - 10 ].…”

Section: Introductionmentioning

confidence: 99%

The Cost of a Locum: A Simulation to Determine When You Are Paying Too Much for Your Anesthesia Locum Tenens Coverage

Cross,

Lolla,

Fichman

et al. 2024

Cureus

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Background: Current research on locum tenens physicians has primarily focused on their safety, reliability, and patient outcomes, leaving a significant gap in understanding the financial implications of their employment in health systems. Amidst a persistent shortage of physicians across specialties, healthcare organizations have increasingly relied on locum tenens to meet the rising demand for clinical services. This study aims to bridge the knowledge gap by evaluating the financial feasibility of employing locum tenens physicians compared to full-time anesthesiologists, given the context of growing physician shortages and increasing healthcare demands. Methods: We developed a Python simulation model to compare the costs of hiring locum tenens versus full-time anesthesiologists. The model inputs included hourly rates for both locum tenens and full-time anesthesiologists and the upfront hiring costs for full-time physicians. By plotting these costs against each other, the model identifies the breakeven point: the number of working hours at which the cost of employing a locum tenens physician equals that of hiring a full-time physician. Utilizing Monte Carlo simulations with data from the Northeastern United States, we assessed the variability and determined an average breakeven point across different scenarios. Results: The Monte Carlo simulation, based on 10,000 iterations, revealed an average breakeven point of 665 hours, corresponding to just over 11 weeks of 60-hour workweeks. This suggests that for any locum tenens engagement exceeding this duration, hiring a full-time anesthesiologist becomes more cost-effective for the healthcare institution. The simulation also showed that 28% of scenarios had a breakeven point below 60 days, highlighting the financial dynamics and decision-making complexities in employing locum tenens versus full-time physicians. Conclusions: The findings indicate that employing locum tenens physicians for durations shorter than 665 hours remains financially viable compared to the option of hiring full-time anesthesiologists. However, the significant variability observed in the simulations underscores the importance of context in making staffing decisions. Healthcare organizations must consider the specific needs and circumstances of their operations when deciding between hiring locum tenens and full-time physicians, especially for longer-term coverage requirements.

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

Cited by 5 publications

References 18 publications

Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report

Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report

Understanding Health Service Utilisation Patterns for Care Home Residents During the COVID-19 Pandemic using Routinely Collected Healthcare Data

The Cost of a Locum: A Simulation to Determine When You Are Paying Too Much for Your Anesthesia Locum Tenens Coverage

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