Empirical Research
Factors Affecting COVID-19 Incidences and Deaths of Geriatric Hospital Patients in Korea
Research in Gerontological Nursing, 2023;16(6):302–311
Abstract
The current retrospective study aimed to investigate the association between organizational factors and nursing staff in geriatric hospitals and coronavirus disease 2019 (COVID-19) incidences and deaths using secondary data from governments nationwide in Korea. We used data on the number of COVID-19–confirmed cases and deaths among older adults in geriatric hospitals and nursing staff levels in those hospitals. We found that when the RN level was higher than the sample mean, the number of COVID-19–confirmed cases by geriatric hospital was significantly lower (4.3%; p = 0.05) and the number of deaths by geriatric hospital was marginally significantly lower (1.4%; p = 0.05). This study presented the national description of geriatric hospitals during the COVID-19 pandemic in terms of organizational and nursing staff factors. Findings highlight the impact of nursing staff skill mix and number of geriatric hospitals during the COVID-19 pandemic in Korea. It is necessary to allocate a realistic designation of infection control staff and establish a clear standard so infection control activities in geriatric hospitals can proceed systematically. [Research in Gerontological Nursing, 16(6), 302–311.]
- (2020). Characteristics of US nursing homes with COVID-19 cases. Journal of the American Geriatrics Society, 68(8), 1653–1656.
10.1111/jgs.16661 PMID:32484912 > Crossref MedlineGoogle Scholar - (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes, 29(3), 322–327.
10.1016/j.rmclc.2018.04.011 > CrossrefGoogle Scholar - (2022). COVID-19 excess mortality among long-term care residents in Ontario, Canada. PLoS One, 17(1), e0262807.
10.1371/journal.pone.0262807 PMID:35051237 > Crossref MedlineGoogle Scholar - (2021). Frailty is associated with in-hospital mortality in older hospitalised COVID-19 patients in the Netherlands: The COVID-OLD study. Age and Ageing, 50(3), 631–640.
10.1093/ageing/afab018 PMID:33951156 > Crossref MedlineGoogle Scholar - (2023). Religion, spirituality, and coping during the pandemic: Perspectives of dementia caregivers. Clinical Nursing Research, 32(1), 94–104.
10.1177/10547738221115239 PMID:35912847 > Crossref MedlineGoogle Scholar - (2007). The influence of staffing characteristics on quality of care in nursing homes. Health Services Research, 42(5), 1822–1847.
10.1111/j.1475-6773.2007.00704.x PMID:17850522 > Crossref MedlineGoogle Scholar - (2019). The Akaike information criterion: Background, derivation, properties, application, interpretation, and refinements. Wiley Interdisciplinary Reviews: Computational Statistics, 11(3), e1460.
10.1002/wics.1460 > CrossrefGoogle Scholar - (2020). Characteristics and quality of US nursing homes reporting cases of coronavirus disease 2019 (COVID-19). JAMA Network Open, 3(7), e2016930.
10.1001/jamanetworkopen.2020.16930 PMID:32725243 > Crossref MedlineGoogle Scholar - (2020). Geriatric medical education in rapidly aging Asia. Aging Medicine and Healthcare, 11(3), 72–73.
10.33879/AMH.113.2020.09032 > CrossrefGoogle Scholar - (2021). Analysis of needs for infection control education in long-term care hospitals for the epidemic of COVID-19: Borich priority formula and the locus for focus model. Health and Social Welfare Review, 41(1), 8–21. > Google Scholar
- (2021). The relationship between quality and staffing in long-term care: A systematic review of the literature 2008–2020. International Journal of Nursing Studies, 122, 104036.
10.1016/j.ijnurstu.2021.104036 PMID:34419730 > Crossref MedlineGoogle Scholar - (2022). Informal caregivers provide considerable front-line support in residential care facilities and nursing homes. Health Affairs (Project Hope), 41(1), 105–111.
10.1377/hlthaff.2021.01239 PMID:34982633 > Crossref MedlineGoogle Scholar - . (2020). High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA, May 2020. Eurosurveillance, 25(22), 2000956.
10.2807/1560-7917.ES.2020.25.22.2000956 PMID:32524949 > Crossref MedlineGoogle Scholar - (2020). Association of nursing home ratings on health inspections, quality of care, and nurse staffing with COVID-19 cases. Journal of the American Medical Association, 324(11), 1103–1105.
10.1001/jama.2020.14709 PMID:32790822 > Crossref MedlineGoogle Scholar - (2021). A rapid systematic review of measures to protect older people in long-term care facilities from COVID-19. BMJ Open, 11, e047012.
10.1136/bmjopen-2020-047012 PMID:34663652 > Crossref MedlineGoogle Scholar - (2020). Staffing levels and COVID 19 cases and outbreaks in U.S. nursing homes. Journal of the American Geriatrics Society, 68(11), 2462–2466.
10.1111/jgs.16787 PMID:32770832 > Crossref MedlineGoogle Scholar - (2021). Factors associated with racial differences in deaths among nursing home residents with COVID-19 infection in the US. JAMA Network Open, 4(2), e2037431.
10.1001/jamanetworkopen.2020.37431 PMID:33566110 > Crossref MedlineGoogle Scholar - (2020). Is there a link between nursing home reported quality and COVID-19 cases? Evidence from California skilled nursing facilities. Journal of the American Medical Directors Association, 21(7), 905–908.
10.1016/j.jamda.2020.06.016 PMID:32674817 > Crossref MedlineGoogle Scholar - . (n.d.a). Announcement of assessment results for geriatric hospitals [website in Korean]. https://www.hira.or.kr/ra/eval/asmInfo.do?evlCd=14&pgmid=HIRAA030004000000 > Google Scholar
- . (n.d.b). Geriatric hospital adequacy assessment result [website in Korean]. https://www.hira.or.kr/ra/eval/asmWrptPopup.do?evlCd=14&pgmid=HIRAA030004000000 > Google Scholar
- (2020). A study on the relationship of infection control performance in a long term care hospital caregivers. Journal of Digital Convergence, 18(1), 187–198.
10.14400/JDC.2020.18.1.187 > CrossrefGoogle Scholar - (2017). Delegation of nursing activities in long-term care hospitals. Journal of Korean Gerontological Nursing, 19(2), 101–112.
10.17079/jkgn.2017.19.2.101 > CrossrefGoogle Scholar - (2020). Development and application of an infection control education program in long-term care hospitals. Korean Journal of Rehabilitation Nursing, 23(2), 158–166.
10.7587/kjrehn.2020.158 > CrossrefGoogle Scholar - (2020). Improvement of infection control system in long-term care facilities after the coronavirus disease outbreak. Korean Journal of Occupational Health Nursing, 29(3), 202–207.
10.5807/kjohn.2020.29.3.202 > CrossrefGoogle Scholar - (2021). Factors influencing healthcare-associated infection control of caregivers. Journal of Korean Critical Care Nursing, 14(1), 63–75.
10.34250/jkccn.2021.14.1.63 > CrossrefGoogle Scholar - (2022). Nurses' experiences of care for patients in coronavirus disease 2019 infection wards during the early stages of the pandemic. Korean Journal of Adult Nursing, 34(1), 109–121.
10.7475/kjan.2022.34.1.109 > CrossrefGoogle Scholar - . (2020). Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility—King County, Washington, March 2020. MMWR. Morbidity and Mortality Weekly Report, 69(13), 377–381.
10.15585/mmwr.mm6913e1 PMID:32240128 > Crossref MedlineGoogle Scholar - (2021). A call to the CMS: Mandate adequate professional nurse staffing in nursing homes. The American Journal of Nursing, 121(3), 24–27.
10.1097/01.NAJ.0000737292.96068.18 PMID:33625007 > Crossref MedlineGoogle Scholar - . (n.d.). Status of Covid-19 occurrence in Korea [website in Korean]. https://ncov.kdca.go.kr/ > Google Scholar
- . (n.d.a). Report on the status of nursing institutions Paragraph 2 of Article 43 [website in Korean]. https://www.law.go.kr/%EB%B2%95%EB%A0%B9/%EA%B5%AD%EB%AF%BC%EA%B1%B4%EA%B0%95%EB%B3%B4%ED%97%98%EB%B2%95 > Google Scholar
- . (n.d.b). Burden rate and amount of some of the principal's contributions, Attached Table 2 of Article 19 of the Enforcement Decree [website in Korean]. https://www.law.go.kr/LSW/lsSc.do?menuId=1&dt=20201211&query=%EA%B5%AD%EB%AF%BC%EA%B1%B4%EA%B0%95%EB%B3%B4%ED%97%98%EB%B2%95&subMenuId=15#J19:0 > Google Scholar
- . (2016). Related to Article 18 (1) of the Enforcement Decree of the Medical Service Act [web-site in Korean]. https://www.moleg.go.kr/lawinfo/nwLwAnInfo.mo?mid=a10106020000&cs_seq=360274&rowIdx=9 > Google Scholar
- . (2021). What kind of nursing homes? What is the difference between a nursing home and a geriatric hospital? [website in Korean]. https://www.dementia.or.kr/general/bbs/index.php?code=story&category=&gubun=&page=1&number=1073&mode=view&keyfield=&key= > Google Scholar
- . (n.d.a). Medical Service Act, Chapter 3, Article 2 [website in Korean]. https://www.law.go.kr/LSW//lsLawLinkInfo.do?lsJoLnkSeq=1010185163&chrClsCd=010202&ancYnChk= > Google Scholar
- . (n.d.b). Welfare of Older Persons Act, Chapter 34: Geriatric medical welfare facilities [website in Korean]. https://www.law.go.kr/LSW//lsLawLinkInfo.do?lsJoLnkSeq=1017518293&chrClsCd=010202&ancYnChk= > Google Scholar
- (2022). Staffing levels and COVID-19 infections and deaths in Korean nursing homes. Policy, Politics & Nursing Practice, 23(1), 15–25.
10.1177/15271544211056051 PMID:34939511 > Crossref MedlineGoogle Scholar - (2020). Racial and ethnic disparities in COVID-19 infections and deaths across U.S. nursing homes. Journal of the American Geriatrics Society, 68(11), 2454–2461.
10.1111/jgs.16847 PMID:32955105 > Crossref MedlineGoogle Scholar - (2020). COVID-19 infections and deaths among Connecticut nursing home residents: Facility correlates. Journal of the American Geriatrics Society, 68(9), 1899–1906.
10.1111/jgs.16689 PMID:32557542 > Crossref MedlineGoogle Scholar - .(2021). Geriatric hospitals, excluding those in charge of infection control. http://www.mediwelfare.com/news/articleView.html?idxno=2708 > Google Scholar
- . (n.d.). Information disclosure system [website in Korean]. https://www.open.go.kr/com/main/mainView.do > Google Scholar
- . (n.d.). Long term care insurance statistical yearbook [website in Korean]. https://www.longtermcare.or.kr/npbs/d/m/000/moveBoardView?menuId=npe0000000780&bKey=B0010&search_boardId=50132 > Google Scholar
- (2020). Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. Journal of the American Medical Association, 323(18), 1775–1776.
10.1001/jama.2020.4683 PMID:32203977 > Crossref MedlineGoogle Scholar - . (n.d.). Nurses. https://data.oecd.org/healthres/nurses.htm > Google Scholar
- (2021). Protecting nursing home residents and staff from COVID-19. The American Journal of Nursing, 121(8), 68–69.
10.1097/01.NAJ.0000767844.13193.8b PMID:34819482 > Crossref MedlineGoogle Scholar - (2018). Factors affecting exercise adherence of the elderly with gerontological hospital. Journal of the Humanities and Social Sciences, 9(1), 413–426.
10.22143/HSS21.9.1.33 > CrossrefGoogle Scholar - . (n.d.). 4.6 How good is the model? https://www.restore.ac.uk/srme/www/fac/soc/wie/research-new/srme/modules/mod4/6/index.html#:∼:text=The%20deviance%2C%20or%20%2D2%20log,the%20less%20accurate%20the%20model > Google Scholar
- (2020). Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19. JAMA Network Open, 3(12), e2029058.
10.1001/jamanetworkopen.2020.29058 PMID:33301018 > Crossref MedlineGoogle Scholar - (2020). COVID-19 exposures and infection control among home care agencies. Archives of Gerontology and Geriatrics, 91, 104214.
10.1016/j.archger.2020.104214 PMID:32768800 > Crossref MedlineGoogle Scholar - (2021). Characteristics of nursing homes by COVID-19 cases among staff: March to August 2020. Journal of the American Medical Directors Association, 22(5), 960–965.e1.
10.1016/j.jamda.2021.02.004 PMID:33705743 > Crossref MedlineGoogle Scholar - (2019). Investigation of longitudinal data analysis: Hierarchical linear model and latent growth model using a longitudinal nursing home dataset. Research in Gerontological Nursing, 12(6), 275–283.
10.3928/19404921-20191024-02 PMID:31755964 > LinkGoogle Scholar - . (2020). COVID-19 in California's nursing homes: Factors associated with cases and deaths. California Health Care Foundation. https://altc.assembly.ca.gov/sites/altc.assembly.ca.gov/files/hearings/COVID19CAsNursingHomesFactorsCasesDeaths.pdf > Google Scholar
- .(2021a).Health insurance statistics: Current status of medical personnel by type of long-term care facility (nurses and other personnel) [website in Korean]. https://kosis.kr/statHtml/statHtml.do?orgId=354&tblId=DT_HIRA4A&conn_path=I2 > Google Scholar
- .(2021b).Status of long-term care facilities by city and province and type [website in Korean]. https://kosis.kr/statHtml/statHtml.do?orgId=354&tblId=DT_MIRE01&conn_path=I2 > Google Scholar
- . (2021c). Status of wards by type of long-term care facility [website in Korean]. https://kosis.kr/statHtml/statHtml.do?orgId=354&tblId=DT_HIRA45_1&conn_path=I2 > Google Scholar
- . (2020). COVID-19 and workers at risk: Examining the long-term care workforce. https://www.kff.org/coronaviruscovid-19/issue-brief/covid-19-and-workers-at-risk-examining-the-long-term-care-workforce/ > Google Scholar
- (2021). COVID-19 outbreaks in care homes during the first wave: Are Care Quality Commission ratings a good predictor of at-risk homes? The Journal of Hospital Infection, 111, 96–101.
10.1016/j.jhin.2020.12.023 PMID:33453350 > Crossref MedlineGoogle Scholar - (2019). A quantitative systematic review of the association between nurse skill mix and nursing-sensitive patient outcomes in the acute care setting. Journal of Advanced Nursing, 75(12), 3404–3423.
10.1111/jan.14194 PMID:31483509 > Crossref MedlineGoogle Scholar - (2021). The association of nursing home quality ratings and spread of COVID-19. Journal of the American Geriatrics Society, 69(8), 2070–2078.
10.1111/jgs.17309 PMID:34058015 > Crossref MedlineGoogle Scholar - (2022). Mortality rate of end-stage kidney disease patients in Taiwan. Journal of the Formosan Medical Association, 121(Suppl. 1), S12–S19.
10.1016/j.jfma.2021.12.015 PMID:34972608 > Crossref MedlineGoogle Scholar - (2022). Long-term care home size association with COVID-19 infection and mortality in Catalonia in March and April 2020. Epidemiologia, 3(3), 369–390.
10.3390/epidemiologia3030029 PMID:36417245 > Crossref MedlineGoogle Scholar
