TY - JOUR ID - 4207 TI - Structural and Managerial Risk Factors for COVID-19 Occurrence in French Nursing Homes JO - International Journal of Health Policy and Management JA - IJHPM LA - en SN - AU - Corvol, Aline AU - Charras, Kevin AU - Prud'homm, Joaquim AU - Lemoine, Fabien AU - Ory, Fabien AU - Viel, Jean François AU - Somme, Dominique AD - CIC 1414, Inserm, CHU Rennes, Univ Rennes, Rennes, France AD - Living Lab Ageing and Vulnerability, CHU Rennes, Rennes, France AD - Inserm, LTSI, UMR 1099, Univ Rennes, Rennes, France AD - Department of Epidemiology and Public Health, CHU Rennes, Univ Rennes, Rennes, France Y1 - 2022 PY - 2022 VL - 11 IS - 11 SP - 2630 EP - 2637 KW - COVID-19 KW - Nursing Home KW - Lockdown KW - Communal Dining KW - Personal Protective Equipment KW - France DO - 10.34172/ijhpm.2022.6741 N2 - Background  Nursing home (NH) residents accounted for half of the deaths during the 2020 spring wave of the coronavirus disease 2019 (COVID-19) epidemic in France. Our objective was to identify structural and managerial factors associated with COVID-19 outbreaks in NHs.Methods  We conducted in July 2020 a retrospective study by questionnaire addressed to NH directors in the Brittany region of France. The questions related to structural characteristics of the establishment, human resources, and crisis management decisions. The primary endpoint was the occurrence of at least one confirmed case of COVID-19 among residents between March 1, 2020 and May 31, 2020. The secondary endpoint was total mortality during this period. We used multivariate regressions to identify factors associated with these outcomes.Results  Responses were collected from 231 NHs hosting 20,881 residents, representing a participation rate of 47%. In 24 (10%) NHs, at least one resident presented confirmed COVID-19. NHs often implemented stringent protective measures, with 65% of them choosing to confine residents to their rooms. In multivariate analysis, factors associated with a reduced risk of case occurrence were in-room meal service, early ban of family visits, and daily access to an outdoor space. No association was found between mortality and the factors studied. Our results show an early and strict implementation of lockdown measures, with good epidemiological results in a context of shortage of personal protective equipment (PPE) and non-vaccination. Nevertheless, it raises ethical questions concerning respect of residents’ wellbeing and rights.Conclusion  Cessation of communal dining seems to be the main measure likely to be effective in preventive terms. It does not seem that room lockdown and cessation of group activities should be recommended, particularly if mask wearing is possible. UR - https://www.ijhpm.com/article_4207.html L1 - https://www.ijhpm.com/article_4207_7da4dda97689876d13cd1ab37f240668.pdf ER -