The Impact of the COVID-19 Pandemic on Staffing Levels in Philadelphia Nursing Homes: Disparities Based on the Racial Composition of Geographical Areas-Reference-Cited by-同舟云学术

The Impact of the COVID-19 Pandemic on Staffing Levels in Philadelphia Nursing Homes: Disparities Based on the Racial Composition of Geographical Areas

Published:2024-08 Issue:3 Volume:25 Page:152-161
ISSN:1527-1544
Container-title:Policy, Politics, & Nursing Practice
language:en
Short-container-title:Policy, Politics, & Nursing Practice

Author:

Tian Junyan¹^ORCID,Gamaldo Alyssa A.²,Madduri Kamesh³,Tavares Carlos⁴,Maseru Noble⁵,Saunders David⁶,King Gary⁷

Affiliation:

1. Human Development and Family Studies, The Pennsylvania State University, State College, PA, USA

2. Department of Psychology, Clemson University, Clemson, SC, USA

3. School of Electrical Engineering and Computer Science, The Pennsylvania State University, State College, PA, USA

4. Anthropology and Sociology, Lafayette College, Easton, PA, USA

5. Schools of Health Sciences Office of Diversity Equity and Inclusion, University of Pittsburgh, Pittsburgh, PA, USA

6. Office of Health Equity, Pennsylvania Department of Health, Harrisburg, PA, USA

7. Biobehavioral Health, The Pennsylvania State University, State College, PA, USA

Abstract

Research to assess and inform health policy is an essential component of the policymaking process to advance equity in public health practice. This study investigated health disparities during the COVID-19 pandemic (2020–2022) in older adult institutional settings in Philadelphia, PA, to inform policy initiatives, interventions, and infrastructure development. We first explored the changing patterns of nursing staffing levels (total direct care staff and registered nurses [RNs]) measured by hours per resident per day (HPRD) before and after COVID-19. Our findings revealed that HPRD levels consistently fell below the Centers for Medicare and Medicaid Services recommended standards from 2018 to 2022, with notable declines observed starting from 2021. Results from multilevel modeling showed significant declines in HPRD for total direct care nursing staff in nursing homes located in zip codes with a high proportion of Black residents (≥40%). In contrast, HPRD for RNs significantly declined in nursing homes located in zip codes with a lower proportion of Black residents (<40%). Moreover, higher reported direct care HPRD and RN HPRD were associated with any reported COVID-19 cases only within zip codes with a low proportion of Black residents. These findings indicate the need for additional policies to address these observed patterns in staffing levels. Our study provides a foundation for future policy reviews utilizing a conceptual framework that is health equity-centric for local and state health departments program and units intended for institutional care settings for older adults.

Funder

Pennsylvania Department of Health

Publisher

SAGE Publications

Link

https://journals.sagepub.com/doi/pdf/10.1177/15271544241270061

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