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Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries?: A cross-sectional survey
Åbo Akademi University, Turku, Finland; Vaasa Central Hospital, Finland.
Åbo Akademi University, Turku, Finland; University South-Eastern Norway, Norway.
Aalborg University, Aalborg East, Denmark.
Finnish Institute for Health and Welfare, Finland.
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2022 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed) Published
Abstract [en]

Aims: To investigate the differences between Sweden, Denmark, Finland and Norway regarding residential/home care units' and frontline managers' background factors, the resources allocated and measures taken during the initial phases of the COVID-19 pandemic, and whether and how these differences were associated with COVID-19 among older people in residential/home units.

Methods: Register- and survey-based data. Responses from managers in municipal and private residential/home units. Number of municipal COVID-19 cases from national registries. Multilevel logistic multivariate regression analysis with presence of COVID-19 among older people in residential/home units as the outcome variable.

Results: The proportions of residential/home units with client COVID-19 cases, mid-March-April 2020 were Denmark 22.7%, Finland 9.0%, Norway 9.7% and Sweden 38.8%, most cases found in clusters. The proportions were similar among employees. Client likelihood of having COVID-19 was six-fold higher if the employees had COVID-19. Mean client cases per residential/home unit were Denmark 0.78, Finland 0.46, Norway 0.22 and Sweden 1.23. For the same municipal infection incidence class, Sweden's mean client infection levels were three-fold those of other countries. The regression analysis variables country, municipal COVID-19 incidence proportion, and care type were associated with client cases at p <= .001. Compared with Denmark, the odds ratios (ORs) for Sweden, Norway and Finland were 1.86, 0.41 and 0.35 respectively. The variable difficulties in preventive testing had an OR of 1.56, p <= .05.

Conclusions: Municipal COVID-19 incidence, employee cases, and the lack of testing resources somewhat explained the confirmed COVID-19 cases among older people in residential/home units. A two- to five-fold unexplained inter-country difference in ORs in the multivariate analyses was notable. The level of protection of vulnerable older clients in municipal and private residential/home units differed between the included countries.

Place, publisher, year, edition, pages
2022.
Keywords [en]
COVID-19, COVID-19 testing, cross-sectional studies, Home Care Services, infection control, multilevel analysis, nursing homes, primary prevention, pandemics, Scandinavian and Nordic countries
National Category
Construction Management Social Work Other Mechanical Engineering
Identifiers
URN: urn:nbn:se:hb:diva-27948DOI: 10.1177/14034948221085398ISI: 000798885400001PubMedID: 35546571Scopus ID: 2-s2.0-85130470420OAI: oai:DiVA.org:hb-27948DiVA, id: diva2:1662265
Available from: 2022-05-31 Created: 2022-05-31 Last updated: 2022-11-24Bibliographically approved

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Solli, RolfWolmesjö, Maria

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