Fatal Underfunding? Explaining COVID-19 Mortality in Spanish Nursing Homes

The COVID-19 pandemic has exerted a disproportionate effect on older European populations living in nursing homes. This article discusses the 'fatal underfunding hypothesis', and reports an exploratory empirical analysis of the regional variation in nursing home fatalities during the first...

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Bibliographic Details
Published in:Journal of aging and health 2021-08, Vol.33 (7-8), p.607-617
Main Authors: Costa-Font, Joan, Jiménez Martin, Sergi, Viola, Analía
Format: Article
Language:English
Subjects:
Aged
Capacity Building
Capital Financing
Continuity of care
Coronaviruses
COVID-19
COVID-19 - mortality
Fatalities
Female
Health Services Needs and Demand
Humans
Hypotheses
Long-Term Care - economics
Male
Mortality
Nursing homes
Nursing Homes - organization & administration
Nursing Homes - standards
Nursing Homes - statistics & numerical data
Pandemics
Personnel Staffing and Scheduling - standards
SARS-CoV-2
Spain - epidemiology
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Summary:The COVID-19 pandemic has exerted a disproportionate effect on older European populations living in nursing homes. This article discusses the 'fatal underfunding hypothesis', and reports an exploratory empirical analysis of the regional variation in nursing home fatalities during the first wave of the COVID-19 pandemic in Spain, one of the European countries with the highest number of nursing home fatalities. We draw on descriptive and multivariate regression analysis to examine the association between fatalities and measures of nursing home organisation, capacity and coordination plans alongside other characteristics. We document a correlation between regional nursing home fatalities (as a share of excess deaths) and a number of proxies for underfunding including nursing home size, occupancy rate and lower staff to a resident ratio (proxying understaffing). Our preliminary estimates reveal a 0.44 percentual point reduction in the share of nursing home fatalities for each additional staff per place in a nursing home consistent with a fatal underfunding hypothesis.
ISSN:0898-2643
1552-6887
DOI:10.1177/08982643211003794