Comparing the Clinical Characteristics and Mortality of Residential and Non-Residential Older People with COVID-19: Retrospective Observational Study.

Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two population groups. Our results showed that the form of presentation of the epidemic outbreak, as well as some risk factors, are different among the elderly institutionalised population with respect to those who are not. In addition to a twenty-fold increase in the rate of adjusted mortality among institutionalised individuals, the peak incidence was delayed by approximately three weeks. Having dementia was shown to be a risk factor for death, and, unlike the non-institutionalised group, neither obesity nor age were shown to be significantly associated with the risk of death among the institutionalised. These differential characteristics should be able to guide the actions to be taken by the health administration in the event of a similar infectious situation among institutionalised elderly people.

[Primary Care frequentation determinants in Catalonia]. / Determinantes de la frecuentación en Atención Primaria en Cataluña.

AIM: To determine which variables determine the average annual attendance time per patient in Primary Care (PC) in Catalonia to improve the adequacy of the budget allocation. DESIGN: Cross-sectional ecological study. SETTING: The Primary Care health centers (EAP) from the Institut Català de la Salut (ICS) in 2016. PARTICIPANTS: The 285 EAPs from the ICS, which cover 75% of citizens over 14 years of age in Catalonia. MAIN MEASUREMENTS: Annual average time of visits by a family doctor per patient for each EAP. It was studied how this time depended on potential explanatory variables, at the EAP level, using linear regression models. RESULTS: the average visit time per patient/year was 49 minutes, varying between 23-87 minutes according to EAP. The EAPs with older population, more comorbidity, more home care, worse socioeconomic index, greater number of young pensioners and greater dispersion had more visiting time, while the EAPs with more population and more women expended less time to visit. These variables explained 64% of the visit time variability. CONCLUSIONS: The budget allocation in PC can be based on a model that incorporates the main determinants of patient' frequentation and adapts to their real needs. It would be necessary to deepen those factors that depend on the professional or health organizations to finish finding an optimal model of resource allocation in the PC.