TY - JOUR
T1 - Excess mortality in residents of aged care facilities during COVID-19 in Australia, 2019–22
AU - Inacio, Maria C.
AU - Davies, Ling
AU - Jorissen, Robert
AU - Air, Tracy
AU - Eshetie, Tesfahun
AU - Mittinty, Murthy
AU - Caughey, Gillian
AU - Miller, Caroline
AU - Wesselingh, Steve
N1 - Publisher Copyright:
© The Author(s) 2023; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - Background: To date, the excess mortality experienced by residential aged care facility (RACF) residents related to COVID-19 has not been estimated in Australia. This study examined (i) the historical mortality trends (2008–09 to 2021–22) and (ii) the excess mortality (2019–20 to 2021–22) of Australian RACF residents. Methods: A retrospective population-based study was conducted using the Australian Institute of Health and Welfare’s GEN website data (publicly available aged care services information). Non-Aboriginal, older (≥65 years old) RACF residents between 2008–09 and 2021–22 were evaluated. The observed mortality rate was estimated from RACF exits compared with the RACF cohort yearly. Direct standardization was employed to estimate age-standardized mortality rates and 95% CIs. Excess mortality and 95% prediction intervals (PIs) for 2019–20 to 2021–22 were estimated using four negative binomial (NB) and NB generalized additive models and compared. Results: The age-standardized mortality rate in 2018–19 was 23 061/100 000 residents (95% CI, 22 711–23 412). This rate remained similar in 2019–20 (23 023/100 000; 95% CI, 22 674–23 372), decreased in 2020–21 (22 559/100 000; 95% CI, 22 210–22 909) and increased in 2021–22 (24 885/100 000; 95% CI, 24 543–25 227). The mortality rate increase between 2020–21 and 2021–22 was observed in all age and sex groups. All models yielded excess mortality in 2021–22. Using the best-performing model (NB), the excess mortality for 2019–20 was –160 (95% PI, –418 to 98), –958 (95% PI, –1279 to –637) for 2020–21 and 4896 (95% PI, 4503–5288) for 2021–22. Conclusions: In 2021–22, RACF residents, who represented <1% of the population, experienced 21% of the Australian national excess mortality (4896/22 886). As Australia adjusts to COVID-19, RACF residents remain a population vulnerable to COVID-19.
AB - Background: To date, the excess mortality experienced by residential aged care facility (RACF) residents related to COVID-19 has not been estimated in Australia. This study examined (i) the historical mortality trends (2008–09 to 2021–22) and (ii) the excess mortality (2019–20 to 2021–22) of Australian RACF residents. Methods: A retrospective population-based study was conducted using the Australian Institute of Health and Welfare’s GEN website data (publicly available aged care services information). Non-Aboriginal, older (≥65 years old) RACF residents between 2008–09 and 2021–22 were evaluated. The observed mortality rate was estimated from RACF exits compared with the RACF cohort yearly. Direct standardization was employed to estimate age-standardized mortality rates and 95% CIs. Excess mortality and 95% prediction intervals (PIs) for 2019–20 to 2021–22 were estimated using four negative binomial (NB) and NB generalized additive models and compared. Results: The age-standardized mortality rate in 2018–19 was 23 061/100 000 residents (95% CI, 22 711–23 412). This rate remained similar in 2019–20 (23 023/100 000; 95% CI, 22 674–23 372), decreased in 2020–21 (22 559/100 000; 95% CI, 22 210–22 909) and increased in 2021–22 (24 885/100 000; 95% CI, 24 543–25 227). The mortality rate increase between 2020–21 and 2021–22 was observed in all age and sex groups. All models yielded excess mortality in 2021–22. Using the best-performing model (NB), the excess mortality for 2019–20 was –160 (95% PI, –418 to 98), –958 (95% PI, –1279 to –637) for 2020–21 and 4896 (95% PI, 4503–5288) for 2021–22. Conclusions: In 2021–22, RACF residents, who represented <1% of the population, experienced 21% of the Australian national excess mortality (4896/22 886). As Australia adjusts to COVID-19, RACF residents remain a population vulnerable to COVID-19.
KW - COVID-19
KW - Residential aged care facilities
KW - mortality
KW - older adults
UR - http://www.scopus.com/inward/record.url?scp=85184837351&partnerID=8YFLogxK
U2 - 10.1093/ije/dyad168
DO - 10.1093/ije/dyad168
M3 - Article
C2 - 38102926
AN - SCOPUS:85184837351
SN - 0300-5771
VL - 53
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 1
M1 - dyad168
ER -