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. 2023 Jun 6;4(2):176-187.
doi: 10.3390/epidemiologia4020019.

Restrictions on Hospital Referrals from Long-Term Care Homes in Madrid and COVID-19 Mortality from March to June 2020: A Systematic Review of Studies Conducted in Spain

Maria Victoria Zunzunegui  1 , François Béland  1 , Fernando J García López  2   3
Affiliations

Restrictions on Hospital Referrals from Long-Term Care Homes in Madrid and COVID-19 Mortality from March to June 2020: A Systematic Review of Studies Conducted in Spain

Maria Victoria Zunzunegui et al. Epidemiologia (Basel). .

Abstract

In March 2020, a ministerial directive issued by the Government of the Community of Madrid (CoM) in Spain included disability-based exclusion criteria and recommendations against hospital referral of patients with respiratory conditions living in long-term care homes (LTCHs). Our objective was to assess whether the hospitalization mortality ratio (HMR) is greater than unity, as would be expected had the more severe COVID-19 cases been hospitalized. Thirteen research publications were identified in this systematic review of mortality by place of death of COVID-19-diagnosed LTCH residents in Spain. In the two CoM studies, the HMRs were 0.9 (95%CI 0.8;1.1) and 0.7 (95%CI 0.5;0.9), respectively. Outside of the CoM, in 9 out of 11 studies, the reported HMRs were between 1.7 and 5, with lower 95% CI limits over one. Evaluation of the disability-based triage of LTCH residents during March-April 2020 in public hospitals in the CoM should be conducted.

Keywords: COVID-19; Spain; hospitalization; long-term care; mortality; older adults; triage.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the systematic review.
Figure 2
Figure 2
Percentage of hospitalizations of LTCH residents diagnosed with COVID-19 in the 13 reviewed studies.
Figure 3
Figure 3
Percentage mortality of LTCH residents diagnosed with COVID-19 in the 13 reviewed studies.
See this image and copyright information in PMC

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References

    1. Zunzunegui M.V., Rico M., Béland F., García-López F.J. The Impact of Long-Term Care Home Ownership and Administration Type on All-Cause Mortality from March to April 2020 in Madrid, Spain. Epidemiologia. 2022;3:323–336. doi: 10.3390/epidemiologia3030025. - DOI - PMC - PubMed
    1. Condes E., Arribas J.R. Impact of COVID-19 on Madrid hospital system. Enferm. Infecc. Microbiol. Clin. 2021;39:256–257. doi: 10.1016/j.eimc.2020.06.005. - DOI - PMC - PubMed
    1. La Comunidad de Madrid Pone en Marcha un Plan Histórico que Unirá la Sanidad Pública y Privada Bajo una Única Coordinación. [(accessed on 5 June 2023)]. Available online: https://www.comunidad.madrid/notas-prensa/2020/03/12/comunidad-madrid-po....
    1. Rico M. Los Seis Documentos que Demuestran que Ayuso Miente Sobre la Orden de no Trasladar Enfermos de Residencias a Hospitales. Infolibre. 2020. [(accessed on 5 June 2023)]. Available online: https://www.infolibre.es/politica/seis-documentos-demuestran-ayuso-mient....
    1. Reyero Zubiri A. Morirán de Forma Indigna. K.O. Ediciones; Madrid, Spain: 2022.

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