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Associations Between Operational Characteristics and COVID-19 Outbreaks in Skilled Nursing Facilities –Allegheny County, PA, 2020

Feng, Vivian (2022) Associations Between Operational Characteristics and COVID-19 Outbreaks in Skilled Nursing Facilities –Allegheny County, PA, 2020. Master Essay, University of Pittsburgh.

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The coronavirus disease 2019 (COVID-19) pandemic impacted many but disproportionately affected nursing home residents, older adults and those with underlying medical conditions – who are often vulnerable to COVID-19 and its adverse outcomes. Previous studies have focused on associations between nursing home characteristics and COVID-19 at the state or multi-state level. The objective of this study is to analyze associations between pre-COVID-19 skilled nursing facility characteristics and 2020 COVID-19 outbreaks in Allegheny County by number of outbreaks by facility, cases per 100,000 person hours, and outbreak duration (days). Studying COVID-19 nursing home outbreaks is crucial to help mitigate future outbreaks in terms of frequency, duration, and severity. Identifying significant factors can direct mitigation recommendations and policy decisions to better protect our older residents.
Data analysis, statistical testing—mainly Fisher’s Exact, Wilcoxon Rank Sum, and Kruskal-Wallis, and quantile regression modeling was performed on the Allegheny County COVID-19 skilled nursing facility 2020 outbreak data from the Pennsylvania National Electronic Disease Surveillance System (PA-NEDSS). Several Centers for Medicare and Medicaid Service (CMS) datasets containing nursing home characteristics were also analyzed.
Fifty-nine Allegheny County skilled nursing facilities and 133 COVID-19 outbreaks met eligibility criteria for analysis –an active facility at the start of 2020, not a hospital-based facility, and outbreaks with at least one COVID-19 case. Overall, any amount of clinical staffing shortages was associated (P <0.05) with outbreak duration (days) in the bivariate and multivariate regression analyses. Survey rating was associated with cases per 100,000 person-hours (P <0.05) in the bivariate and regression analyses. Presence of any nursing/physician deficiencies was significantly associated (P <0.01) with the number of COVID-19 outbreaks in a facility in the bivariate analysis.
The results of this analysis have demonstrated that specific skilled nursing facility characteristics may provide insight to the magnitude and length of facilities’ COVID-19 outbreaks. Continuous research, surveillance, and changes in skilled nursing facilities are needed to monitor and mitigate the spread and effects of COVID-19. This study is of public health relevance because it helps inform future research and decision making necessary to control transmission of the SARS-CoV-2 virus in nursing homes.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Feng, Vivianvfeng09@gmail.comvif16
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairHaggerty, Catherinehaggertyc@edc.pitt.eduhaggertycUNSPECIFIED
Committee MemberDegenholtz, Howardhoward.degenholtz@pitt.eduhoward.degenholtzUNSPECIFIED
Committee MemberMertz, Kristenkristen.mertz@allgehenycounty.usUNSPECIFIEDUNSPECIFIED
Committee MemberFiddner, Jenniferjennifer.fiddner@alleghenycounty.usUNSPECIFIEDUNSPECIFIED
Date: 17 May 2022
Date Type: Completion
Submission Date: 27 April 2022
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 35
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: COVID-19, Skilled Nursing Facility, Coronavirus, Outbreaks, Allegheny County, Pennsylvania
Date Deposited: 17 May 2022 13:52
Last Modified: 17 May 2024 05:15


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