Thursday, February 11, 2021

Size of PA County Elderly Population Predicts Smaller Nursing Home COVID-19 Mortality

This week I thought I would take a look at mortality in nursing homes (or Long Term Care Facilities (LTCF)) in Pennsylvania.  Statewide, nursing home deaths account for 52.1% of the total coronavirus deaths.  Looking at the county level there is considerable variability in the rates where the 10 counties with the highest rates are seen below.  The rates for this group rage from 115.8% for Forest county to 67.2% for Delaware County.  Forest county actually has 3 more LTCF deaths than total deaths with one facility.  This suggests that at least 3 of their residents reside outside the county.  You can see the full list of counties here.

Facility County

Number of Facilities with Cases

Number of Cases Among Residents

Number of Cases Among Employees

Number of Deaths in LTCF

Total Deaths in the County

% of death in LTCF

Case Mortality in LTCF

FOREST

1

121

26

22

19

115.8%

15.0%

ERIE

35

1354

717

287

363

79.1%

13.9%

MCKEAN

9

372

110

47

60

78.3%

9.8%

CENTRE

16

675

146

155

203

76.4%

18.9%

BUTLER

29

1421

156

257

350

73.4%

16.3%

LACKAWANNA

35

1423

295

290

395

73.4%

16.9%

LYCOMING

19

922

283

165

232

71.1%

13.7%

MONTGOMERY

111

4723

186

1026

1456

70.5%

20.9%

CARBON

7

407

48

95

138

68.8%

20.9%

DELAWARE

59

3197

871

796

1184

67.2%

19.6%

The bottom 10 counties are listed below.  The percentage of deaths in the in LTCFs for this group rage from 35.7% in Sullivan County to 15.0% in Potter County.  Surprisingly, Philadelphia county is in this bottom tier with 26.1% of their deaths in LTCFs.  Another way of looking at mortality in LTCFs is the case mortality or the % of cases who have died.  Philadelphia ranks 11th in the state on this measure with Pike county ranking 1st at 27.0% and Cameron County ranking last at 4.3%.

Facility County

Number of Facilities with Cases

Number of Cases Among Residents

Number of Cases Among Employees

Number of Deaths in LTCF

Total Deaths in the County

% of death in LTCF

Case Mortality in LTCF

SULLIVAN

3

94

13

5

14

35.7%

4.7%

WAYNE

5

88

19

20

58

34.5%

18.7%

BEDFORD

5

269

29

43

126

34.1%

14.4%

FRANKLIN

26

799

94

106

313

33.9%

11.9%

CAMERON

1

36

10

2

7

28.6%

4.3%

SNYDER

2

124

31

20

73

27.4%

12.9%

PHILADELPHIA

85

4222

16

782

3001

26.1%

18.5%

ELK

3

122

50

8

34

23.5%

4.7%

CLINTON

6

112

48

9

53

17.0%

5.6%

POTTER

3

45

15

3

20

15.0%

5.0%


I looked at the percentage of the population in each county over the age of 65 and found some interesting patterns.  For the correlation with % of deaths in LTCFs, as the proportion of the population over 65 increases the % of deaths decreases as seen with the graph below.  Forest county is an outlier and is labeled green in the scatterplot.  With Forest county included, this relationship accounts for 6% of the variability in the data.  When Forest county is excluded, the relationship accounts for 11.6% of the variability in the data and is still negative.  I don't have a good explanation for this but will investigate further.


I then looked at the correlation between case mortality and the % of the county over 65.  This relationship was also negative accounting for 11.3% of the variability.  Pike county is a mild outlier.  With Pike excluded, this relationship accounts for 16.6% of the variability.  This pattern is similar to the one with the percentage of deaths in the county.  

 

Case mortality and % of deaths in LTCFs are positively associated but not strongly accounting for 15.3% of the variability.  There may be stronger relations ships among the variables not considered yet.  There also may be variables at the facility level to which I do not have access.  Investigating will continue.

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