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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