Institutional Capacity of Long-Term Care Facilities in China During the COVID-19 Pandemic
Main Article Content
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has heavily impacted long-term care facilities (LTCFs) worldwide, resulting in extremely high infection and death rates within these settings. One major factor is the limited institutional capacity of long-term care facilities to respond effectively to such public health emergencies. However, there is limited research on this topic, especially concerning China. Therefore, this study seeks to examine the institutional capacities of long-term care facilities of China to better understand these challenges and identify measures for improving long-term care provision in future public health emergencies.
Objective: To assess the institutional capacity of Chinese long-term care facilities during public health emergencies.
Methods: A cross-sectional study collected data from 104 long-term care facilities across 20 provincial capitals or prefecture-level cities in China through questionnaires. Institutional capacity was measured with the social organization development index encompassing six dimensions: activity, resources, structure, environment, value and influence.
Results: Institutional capacity encompassing six dimensions showed scores of 76%, 63%, 95.9%, 75.4%, 63.1% and 74.1% in Activity, Resources, Structure, Environment, Value and Influence, respectively. These results indicate areas of strength, as well as notable gaps where improvements would be needed.
Conclusion: The social organization development index provides a comprehensive framework for assessing the institutional capacities of long-term care facilities and their roles during a public health crisis. The findings may offer insights into government policymaking related to the industry, particularly in enhancing institutional capacities to improve virus prevention and control during future public health emergencies.
Article Details
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References
2. Fisman DN, et al. Risk factors associated with mortality among residents with coronavirus disease 2019 (COVID-19) in long-term care facilities in Ontario, Canada. JAMA Netw Open. 2020;3(7):e2015957. doi:10.1001/jamanetworkopen.2020.15957.
3. Canadian Institute for Health Information. Long-term care and COVID-19: international comparisons. Published 2023. https://www.cihi.ca/en/long-term-care-and-covid-19-international-comparisons.
4. Barnett ML, Grabowski DC. Nursing homes are ground zero for COVID-19 pandemic. JAMA Health Forum. 2020;1(3):e200369. doi:10.1001/jamahealthforum.2020.0369.
5. Cronin CJ, Evans WN. Nursing home quality, COVID-19 deaths, and excess mortality. J Health Econ. 2022;82:102592. doi:10.1016/j.jhealeco.2022.102592.
6. European Centre for Disease Prevention and Control. Surveillance data from public online national reports on COVID-19 in long-term care facilities. Published 2021. https://www.ecdc.europa.eu/en/all-topics-z/coronavirus/threats-and-outbreaks/covid-19/prevention-and-control/LTCF-data.
7. Curiskis A, et al. What we know—and what we don’t know—about the impact of the pandemic on our most vulnerable community. Published 2021. https://covidtracking.com/analysis-updates/what-we-know-about-the-impact-of-the-pandemic-on-our-most-vulnerable-community.
8. Comas-Herrera A, et al. Mortality associated with COVID-19 in care homes: international evidence. International Long-term Care Policy Network (ILPN); 2021.
9. Lu Q, et al. Social policy responses to the Covid-19 crisis in China in 2020. Int J Environ Res Public Health. 2020;17(16):5597. doi:10.3390/ijerph17165597.
10. Cazzoletti L, et al. Risk factors associated with nursing home COVID-19 outbreaks: a retrospective cohort study. Int J Environ Res Public Health. 2021;18(16):8696. doi:10.3390/ijerph18168696.
11. Li Z. How can private elderly care institutions get out of the epidemic "swamp" after their income plummeted by 20%. Published April 29, 2020. https://m.gmw.cn/baijia/2020-04/29/33794113.html.
12. Dykgraaf SH, et al. Protecting nursing homes and long-term care facilities from COVID-19: a rapid review of international evidence. J Am Med Dir Assoc. 2021;22(10):1969-1988. doi:10.1016/j.jamda.2021.06.027.
13. Ham C. A home by any other name: building an understanding of infection prevention in small residential care facilities. Public Policy & Aging Report. 2022;32(4):140-145.
14. Létourneau J, et al. Identifying performance factors of long-term care facilities in the context of the COVID-19 pandemic: a scoping review protocol. Syst Rev. 2022;11(1):203. doi:10.1186/s13643-022-01975-6.
15. Fleming SP, et al. COVID-19 cases, hospitalizations, and deaths in nursing homes: factors impacting the second surge. Innov Aging. 2021;5:15-16.
16. Yin C, et al. Factors associated with nursing home residents’ COVID-19 infections: a systematic review of literature. Innov Aging. 2021;5:16-16.
17. Ministry of Civil Affairs of the People’s Republic of China. China Civil Affairs Statistical Yearbook. Beijing, China: China Social Press; 2020.
18. Frank L, Concannon T, Patel K. Health care resource allocation decision-making during a pandemic. Santa Monica, CA: RAND Corporation; 2020.
19. Abbasi J. “Abandoned” nursing homes continue to face critical supply and staff shortages as COVID-19 toll has mounted. JAMA. 2020;324(2):123-125.
20. United States Agency for International Development. Organizational performance index: definitions and measurements. https://pdf.usaid.gov/pdf_docs/PA00XM82.pdf .