Caring for nursing home residents with COVID-19: a "hospital-at-nursing home" intermediate care intervention

被引：15

作者：

Benvenuti, Enrico ^{[1
]}

Rivasi, Giulia ^{[2
]}

Bulgaresi, Matteo ^{[1
]}

Barucci, Riccardo ^{[1
]}

Lorini, Chiara ^{[3
]}

Balzi, Daniela ^{[4
]}

Faraone, Antonio ^{[5
]}

Fortini, Giacomo ^{[1
]}

Vaccaro, Gabriele ^{[3
]}

Del Lungo, Ilaria ^{[1
]}

Gangemi, Salvatore ^{[1
]}

Giardini, Sante ^{[1
]}

Piga, Cecilia ^{[1
]}

Barghini, Eleonora ^{[1
]}

Boni, Serena ^{[1
]}

Bulli, Giulia ^{[1
]}

Carrai, Paolo ^{[5
]}

Crociani, Andrea ^{[5
]}

Lo Forte, Aldo ^{[5
]}

Martella, Letizia ^{[1
]}

Pupo, Simone ^{[1
]}

Marozzi, Irene ^{[2
]}

Bandini, Giulia ^{[6
]}

Buscemi, Primo ^{[3
]}

Cosma, Claudia ^{[3
]}

Stacchini, Lorenzo ^{[3
]}

Baggiani, Lorenzo ^{[7
]}

Ungar, Andrea ^{[2
]}

Mossello, Enrico ^{[2
]}

Bonaccorsi, Guglielmo ^{[3
]}

Landini, Giancarlo ^{[8
]}

机构：

[1] Santa Maria Annunziata Hosp, Local Hlth Unit Toscana Ctr, Geriatr Unit, Florence, Italy

[2] Univ Florence, Azienda Osped Univ Careggi, Careggi Hosp, Div Geriatr & Intens Care Med, Largo Brambilla 3, I-50139 Florence, Italy

[3] Univ Florence, Dept Hlth Sci, Florence, Italy

[4] Local Hlth Unit Toscana Ctr, Epidemiol Unit, Florence, Italy

[5] San Giovanni Dio Hosp, Dept Internal Med, Florence, Italy

[6] Careggi Hosp, Div Internal Med, Florence, Italy

[7] Dept Terr Hlth Network, Florence, Italy

[8] Santa Maria Nuova Hosp, Local Hlth Unit Toscana Ctr, Dept Internal Med, Florence, Italy

来源：

AGING CLINICAL AND EXPERIMENTAL RESEARCH | 2021年 / 33卷 / 10期

关键词：

Nursing home; Mortality; COVID-19; Intermediate care; Integrated medicine; Hospital-at-home; OLDER-PEOPLE; MORTALITY; SYMPTOMS; END;

D O I：

10.1007/s40520-021-01959-z

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Background Nursing home (NH) residents have been dramatically affected by COVID-19, with extremely high rates of hospitalization and mortality. Aims To describe the features and impact of an assistance model involving an intermediate care mobile medical specialist team (GIROT, Gruppo Intervento Rapido Ospedale Territorio) aimed at delivering "hospital-at-nursing home" care to NH residents with COVID-19 in Florence, Italy. Methods The GIROT activity was set-up during the first wave of the pandemic (W1, March-April 2020) and became a structured healthcare model during the second (W2, October 2020-January 2021). The activity involved (1) infection transmission control among NHs residents and staff, (2) comprehensive geriatric assessment including prognostication and geriatric syndromes management, (3) on-site diagnostic assessment and protocol-based treatment of COVID-19, (4) supply of nursing personnel to understaffed NHs. To estimate the impact of the GIROT intervention, we reported hospitalization and infection lethality rates recorded in SARS-CoV-2-positive NH residents during W1 and W2. Results The GIROT activity involved 21 NHs (1159 residents) and 43 NHs (2448 residents) during W1 and W2, respectively. The percentage of infected residents was higher in W2 than in W1 (64.5% vs. 38.8%), while both hospitalization and lethality rates significantly decreased in W2 compared to W1 (10.1% vs 58.2% and 23.4% vs 31.1%, respectively). Discussion Potentiating on-site care in the NHs paralleled a decrease of hospital admissions with no increase of lethality. Conclusions An innovative "hospital-at-nursing home" patient-centred care model based on comprehensive geriatric assessment may provide a valuable contribution in fighting COVID-19 in NH residents.

引用

页码：2917 / 2924

页数：8

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