Frontiers in Public Health (Jul 2025)

The impact of COVID-19 hospitalizations on nursing home admissions: a regional insight into long-term care and public health

  • Alessandra Bandera,
  • Alessandra Bandera,
  • Marta Colaneri,
  • Alessia Antonella Galbussera,
  • Marta Canuti,
  • Lucia Dall’Olio,
  • Alessandro Nobili,
  • Massimo Puoti,
  • Giulia Carla Marchetti,
  • Simone Piva,
  • Simone Piva,
  • Pierluigi Plebani,
  • Mario Raviglione,
  • Andrea Gori,
  • Danilo Cereda,
  • Olivia Leoni,
  • Ida Fortino,
  • Maria Luisa Ojeda Fernandez,
  • Pier Mannuccio Mannucci,
  • Pasquale Agosti,
  • Pasquale Agosti,
  • Fabrizio Tediosi,
  • Marta Baviera,
  • Mauro Tettamanti

DOI
https://doi.org/10.3389/fpubh.2025.1613684
Journal volume & issue
Vol. 13

Abstract

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BackgroundTo obtain the rate of admission to nursing homes (NHs) and to evaluate clinical characteristics and mortality rates of patients admitted to NHs after hospitalizations for COVID-19, compared to non-COVID-19 acutely hospitalized patients.MethodsWe analyzed administrative data from Lombardy, a Northen Italian region, in individuals aged ≥50 years who were hospitalized and discharged alive in 2018 for acute conditions or, between February 2020 and June 2022, for COVID-19. Outcomes included NH institutionalization rates within 180 post-discharge day and mortality following NH admission. Kaplan–Meier curves and Cox proportional hazard models adjusted for age, sex, and comorbidities were used to assess the risks.ResultsAmong 133,216 COVID-19 hospitalizations in 2020–2022 and 239,099 acute hospitalizations in 2018, institutionalization rates within 180 post-discharge days were similar (3.7% for both cohorts). However, COVID-19 patients had higher adjusted risks of institutionalization (HR 1.70; 95% CI 1.63–1.78) and mortality within 6 months after NH admission (HR 2.08; 95% CI 1.90–2.27). Differences were more pronounced when considering patients hospitalized during the first COVID-19 pandemic wave.ConclusionCOVID-19 hospitalization significantly increases the risks of admission to NHs and early mortality after institutionalization in older individuals compared to hospitalizations due to other acute conditions.

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