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Front Public Health
. 2025 Jul 18:13:1613684.
doi: 10.3389/fpubh.2025.1613684. eCollection 2025. The impact of COVID-19 hospitalizations on nursing home admissions: a regional insight into long-term care and public health
Alessandra Bandera # 1 2 , Marta Colaneri # 3 , Alessia Antonella Galbussera 4 , Marta Canuti 5 , Lucia Dall'Olio 6 , Alessandro Nobili 4 , Massimo Puoti 7 , Giulia Carla Marchetti 8 , Simone Piva 9 10 , Pierluigi Plebani 11 , Mario Raviglione 6 , Andrea Gori 3 , Danilo Cereda 12 , Olivia Leoni 12 , Ida Fortino 12 , Maria Luisa Ojeda Fernandez 4 , Pier Mannuccio Mannucci 13 , Pasquale Agosti 2 13 , Fabrizio Tediosi 6 , Marta Baviera 4 , Mauro Tettamanti 4
Affiliations
Background: To obtain the rate of admission to nursing homes (NHs) and to evaluate clinical characteristics and mortality rates of patients admitted to NHs after hospitalizations for COVID-19, compared to non-COVID-19 acutely hospitalized patients.
Methods: We analyzed administrative data from Lombardy, a Northen Italian region, in individuals aged ≥50 years who were hospitalized and discharged alive in 2018 for acute conditions or, between February 2020 and June 2022, for COVID-19. Outcomes included NH institutionalization rates within 180 post-discharge day and mortality following NH admission. Kaplan-Meier curves and Cox proportional hazard models adjusted for age, sex, and comorbidities were used to assess the risks.
Results: Among 133,216 COVID-19 hospitalizations in 2020-2022 and 239,099 acute hospitalizations in 2018, institutionalization rates within 180 post-discharge days were similar (3.7% for both cohorts). However, COVID-19 patients had higher adjusted risks of institutionalization (HR 1.70; 95% CI 1.63-1.78) and mortality within 6 months after NH admission (HR 2.08; 95% CI 1.90-2.27). Differences were more pronounced when considering patients hospitalized during the first COVID-19 pandemic wave.
Conclusion: COVID-19 hospitalization significantly increases the risks of admission to NHs and early mortality after institutionalization in older individuals compared to hospitalizations due to other acute conditions.
Keywords: COVID-19; administrative databases; institutionalization; nursing home; post-acute care.
. 2025 Jul 18:13:1613684.
doi: 10.3389/fpubh.2025.1613684. eCollection 2025. The impact of COVID-19 hospitalizations on nursing home admissions: a regional insight into long-term care and public health
Alessandra Bandera # 1 2 , Marta Colaneri # 3 , Alessia Antonella Galbussera 4 , Marta Canuti 5 , Lucia Dall'Olio 6 , Alessandro Nobili 4 , Massimo Puoti 7 , Giulia Carla Marchetti 8 , Simone Piva 9 10 , Pierluigi Plebani 11 , Mario Raviglione 6 , Andrea Gori 3 , Danilo Cereda 12 , Olivia Leoni 12 , Ida Fortino 12 , Maria Luisa Ojeda Fernandez 4 , Pier Mannuccio Mannucci 13 , Pasquale Agosti 2 13 , Fabrizio Tediosi 6 , Marta Baviera 4 , Mauro Tettamanti 4
Affiliations
- PMID: 40756386
- PMCID: PMC12315697
- DOI: 10.3389/fpubh.2025.1613684
Background: To obtain the rate of admission to nursing homes (NHs) and to evaluate clinical characteristics and mortality rates of patients admitted to NHs after hospitalizations for COVID-19, compared to non-COVID-19 acutely hospitalized patients.
Methods: We analyzed administrative data from Lombardy, a Northen Italian region, in individuals aged ≥50 years who were hospitalized and discharged alive in 2018 for acute conditions or, between February 2020 and June 2022, for COVID-19. Outcomes included NH institutionalization rates within 180 post-discharge day and mortality following NH admission. Kaplan-Meier curves and Cox proportional hazard models adjusted for age, sex, and comorbidities were used to assess the risks.
Results: Among 133,216 COVID-19 hospitalizations in 2020-2022 and 239,099 acute hospitalizations in 2018, institutionalization rates within 180 post-discharge days were similar (3.7% for both cohorts). However, COVID-19 patients had higher adjusted risks of institutionalization (HR 1.70; 95% CI 1.63-1.78) and mortality within 6 months after NH admission (HR 2.08; 95% CI 1.90-2.27). Differences were more pronounced when considering patients hospitalized during the first COVID-19 pandemic wave.
Conclusion: COVID-19 hospitalization significantly increases the risks of admission to NHs and early mortality after institutionalization in older individuals compared to hospitalizations due to other acute conditions.
Keywords: COVID-19; administrative databases; institutionalization; nursing home; post-acute care.