Mortality Rates From COVID-19 Are Lower In Unionized Nursing Homes.

  title={Mortality Rates From COVID-19 Are Lower In Unionized Nursing Homes.},
  author={Adam Dean and Atheendar S. Venkataramani and Simeon D Kimmel},
  journal={Health affairs},
More than 40% of all reported coronavirus disease 2019 (COVID-19) deaths in the United States have occurred in nursing homes. As a result, health care worker access to personal protective equipment (PPE) and infection control policies in nursing homes have received increased attention. However, it is not known if the presence of health care worker unions in nursing homes is associated with COVID-19 mortality rates. Therefore, we used cross-sectional regression analysis to examine the… 

Resident Mortality And Worker Infection Rates From COVID-19 Lower In Union Than Nonunion US Nursing Homes, 2020-21.

Examination of data on nursing home-level union status from the Service Employees International Union for all forty-eight continental US states from June 8, 2020, through March 21, 2021 found that unions were associated with 10.8 percent lower resident COVID-19 mortality rates, as well as 6.8-percent lower worker CO VID-19 infection rates.

Comparison of resident COVID-19 mortality between unionized and nonunionized private nursing homes

Higher average resident age, lower percentage of Medicare residents, small size, for-profit ownership, and chain organization affiliation were associated with higher resident COVID-19 mortality percentage.

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Standardized safety measures implemented in nursing homes seemed to help minimize differences in COVID-19 cases between nursing facilities, and the interaction of nursing home location and resident racial composition was associated with the number of nursing care home CO VID-19 deaths.

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Staff turnover was associated with an increased likelihood of an infection control citation and was positively associated with the infraction scope being coded as a “pattern” or “widespread” in a citation.

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A rapid literature review of the relationship between ownership structure of nursing homes and their performance during the COVID-19 pandemic found the majority of papers found a significant relationship in the unadjusted statistics between ownership status and effectiveness in response to the pandemic.

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For-profit status was a consistent risk factor for higher cumulative COVID-19 infections and deaths and ownership among providers may be a key modifiable factor which can be regulated to improve health outcomes in vulnerable populations and reduce health disparities.



Characteristics of U.S. Nursing Homes with COVID‐19 Cases

Larger facility size, urban location, greater percentage of African American residents, non‐chain status, and state were significantly related to the increased probability of having a COVID‐19 case.

Severe Staffing And Personal Protective Equipment Shortages Faced By Nursing Homes During The COVID-19 Pandemic.

It is found that more than 1 in 5 nursing homes report a severe shortage of PPE and any shortage of staff, and rates of both staff and PPE shortages did not meaningfully improve from May to July of 2020.

Nurse Unions and Patient Outcomes

The authors estimate the impact of nurse unions on health care quality using patient-discharge data and the universe of hospital unionization in California between 1996 and 2005. They find that

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Long-term care facilities should take proactive steps to protect the health of residents and preserve the health care workforce by identifying and excluding potentially infected staff members and visitors, ensuring early recognition of potentially infected patients, and implementing appropriate infection control measures.

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The authors find that hospitals with unionized R.N.N.'s have 5.5% lower heart-attack mortality than do non-union hospitals, and this result remains substantively unchanged when the analysis accounts for possible selection bias.

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In hospitals with high patient- to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.