Long-Term Care Resident Health and Quality of Care During the COVID-19 Pandemic: A Synthesis Analysis of Canadian Institute for Health Information Data Tables.

Objective: Long-term care (LTC) homes ("nursing homes") were challenged during the first year of the COVID-19 pandemic in Canada. The objective of this study was to measure the impact of the COVID-19 pandemic on resident admission and discharge rates, resident health attributes, treatments, and quality of care. Design: Synthesis analysis of "Quick Stats" standardized data table reports published yearly by the Canadian Institute for Health Information. These reports are a pan-Canadian scorecard of LTC services rendered, resident health characteristics, and quality indicator performance. Setting and participants: LTC home residents in Alberta, British Columbia, Manitoba, and Ontario, Canada that were assessed with the interRAI Minimum Data Set 2.0 comprehensive health assessment in fiscal years 2018/2019, 2019/2020 (pre-pandemic period), and 2020/2021 (pandemic period). Methods: Risk ratio statistics were calculated to compare admission and discharge rates, validated interRAI clinical summary scale scores, medication, therapy and treatment provision, and seventeen risk-adjusted quality indicator rates from the pandemic period relative to prior fiscal years. Results: Risk of dying in the LTC home was greater in all provinces (risk ratio [RR] range 1.06-1.18) during the pandemic. Quality of care worsened substantially on 6 of 17 quality indicators in British Columbia and Ontario, and 2 quality indicators in Manitoba and Alberta. The only quality indicator where performance worsened during the pandemic in all provinces was the percentage of residents that received antipsychotic medications without a diagnosis of psychosis (RR range 1.01-1.09). Conclusions and implications: The COVID-19 pandemic has unveiled numerous areas to strengthen LTC and ensure that resident's physical, social, and psychological needs are addressed during public health emergencies. Except an increase in potentially inappropriate antipsychotic use, this provincial-level analysis indicates that most aspects of resident care were maintained during the first year of the COVID-19 pandemic.

Filling Data Gaps in Access to Mental Health and Substance Use Services.

Improving access to mental health and substance use (MHSU) services continues to be an area of growing concern in Canada, amplified by the consequences of the COVID-19 pandemic. It was also identified as a priority for federal, provincial and territorial governments in the Shared Health Priorities (SHP) work (CIHI n.d.a.). As part of the SHP work, the Canadian Institute for Health Information recently released 2022 results for two newly developed indicators that help to fill data and information gaps in understanding access to MHSU services in Canada. The first, "Early Intervention for Mental Health and Substance Use among Children and Youth," showed that three in five children and youth (aged 12-24 years) with self-reported early needs accessed at least one community MHSU service in Canada. The second, "Navigation of Mental Health and Substance Use Services," revealed that two out of five Canadians (15 years and older) who accessed at least one MHSU service said that they always or usually had support navigating their services.