Abstract Background The population of adult residential care homes has been shown to have high morbidity and mortality in relation to COVID‐19. Methods We examined 3115 hospital discharges to a national cohort of 1068 adult care homes and subsequent outbreaks of COVID‐19 occurring between 22 February and 27 June 2020. A Cox proportional hazards regression model was used to assess the impact of time‐dependent exposure to hospital discharge on incidence of the first known outbreak, over a window of 7‐21 days after discharge, and adjusted for care home characteristics, including size and type of provision. Results A total of 330 homes experienced an outbreak, and 544 homes received a discharge over the study period. Exposure to hospital discharge was not associated with a significant increase in the risk of a new outbreak (hazard ratio 1.15, 95% CI 0.89, 1.47, P = .29) after adjusting for care home characteristics. Care home size was the most significant predictor. Hazard ratios (95% CI) in comparison with homes of <10 residents were as follows: 3.40 (1.99, 5.80) for 10‐24 residents; 8.25 (4.93, 13.81) for 25‐49 residents; and 17.35 (9.65, 31.19) for 50+ residents. When stratified for care home size, the outbreak rates were similar for periods when homes were exposed to a hospital discharge, in comparison with periods when homes were unexposed. Conclusion Our analyses showed that large homes were at considerably greater risk of outbreaks throughout the epidemic, and after adjusting for care home size, a discharge from hospital was not associated with a significant increase in risk.
【저자키워드】 care homes, outbreak, COVID‐19 pandemic, hospital discharge, long‐term care, time‐dependent Cox regression, 【초록키워드】 hospital, risk, discharge, COVID‐19, Cohort, Characteristics, Regression model, morbidity and mortality, incidence, Care, Analysis, exposure to, 95% CI, significant increase, hazard ratio, study period, hazard, National, the epidemic, Result, greater, shown, was used, examined, subsequent, adjusted, stratified, Cox proportional hazard, 【제목키워드】 hospital, COVID‐19, Care, Factor, National, cohort analysis,