The impact of Covid-19 hospitalizations on nursing home admissions

A regional insight into long-term care and public health

Bibliographic Data

ID22076668
AuthorsAlessandra Bandera (0000-0001-9440-4601, University of Milan, corresponding author), Marta Colaneri (0000-0002-5939-9576, ASST Fatebenefratelli Sacco), Alessia Antonella Galbussera (0000-0003-0163-1034, Mario Negri Institute for Pharmacological Research), Marta Canuti (0000-0002-9959-128X, University of Copenhagen), Lucia Dall’Olio (University of Milan), Alessandro Nobili (0000-0002-7813-0572, Mario Negri Institute for Pharmacological Research, corresponding author), Massimo Puoti (0000-0003-3278-7138, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Giulia Marchetti (0000-0002-4498-4828, University of Milan), Giulia Carla Marchetti, Simone Piva (0000-0002-5483-8007, Surgical Specialties (Canada)), Pierluigi Plebani (0000-0001-8245-226X, Politecnico di Milano), Mario Raviglione (0000-0002-9331-2067, University of Milan), Andrea Gori (0009-0005-6356-9266, ASST Fatebenefratelli Sacco), Danilo Cereda (0000-0001-5945-5710, Ministero della Salute), Olivia Leoni (0000-0002-6906-2424, Ministero della Salute), Ida Fortino (0009-0005-6006-0376, Ministero della Salute), Maria Luisa Ojeda Fernandez, Luisa Ojeda‐Fernández (0000-0003-2920-1669, Mario Negri Institute for Pharmacological Research), Pier Mannuccio Mannucci (0000-0002-1915-3897, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Pasquale Agosti (0000-0002-1239-775X, University of Milan), Fabrizio Tediosi (0000-0001-8671-9400, University of Milan), Marta Baviera (0000-0002-0264-151X, Mario Negri Institute for Pharmacological Research), Mauro Tettamanti (0000-0001-7345-0887, Mario Negri Institute for Pharmacological Research)
Year2025
Volume13
Pages1613684-1613684
Publication date2025-07-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1613684
PMID40756386
OpenAlexW4412957170
LanguageEN
References cited34

Background: To obtain the rate of admission to nursing homes (NHs) and to evaluate clinical characteristics and mortality rates of patients admitted to NHs after hospitalizations for COVID-19, compared to non-COVID-19 acutely hospitalized patients. Methods: We analyzed administrative data from Lombardy, a Northen Italian region, in individuals aged ≥50 years who were hospitalized and discharged alive in 2018 for acute conditions or, between February 2020 and June 2022, for COVID-19. Outcomes included NH institutionalization rates within 180 post-discharge day and mortality following NH admission. Kaplan-Meier curves and Cox proportional hazard models adjusted for age, sex, and comorbidities were used to assess the risks. Results: Among 133,216 COVID-19 hospitalizations in 2020-2022 and 239,099 acute hospitalizations in 2018, institutionalization rates within 180 post-discharge days were similar (3.7% for both cohorts). However, COVID-19 patients had higher adjusted risks of institutionalization (HR 1.70; 95% CI 1.63-1.78) and mortality within 6 months after NH admission (HR 2.08; 95% CI 1.90-2.27). Differences were more pronounced when considering patients hospitalized during the first COVID-19 pandemic wave. Conclusion: COVID-19 hospitalization significantly increases the risks of admission to NHs and early mortality after institutionalization in older individuals compared to hospitalizations due to other acute conditions

Confidence interval · Disease · Hazard ratio · Institutionalisation · Pandemic · Proportional hazards model · Psychiatry · Public health · Chronic Disease Management Strategies · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing · Emergency Medicine · Internal Medicine · Pediatrics