Staffing levels and expenses in Canadian long-term care facilities by ownership status before and during the COVID-19 pandemic.

IF 3.3 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Health Reports Pub Date : 2025-07-16 DOI:10.25318/82-003-x202500700001-eng

Valentina Antonipillai, Edward Ng, Andrea Baumann, Mary Crea-Arsenio, Rochelle Garner

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引用次数: 0

Abstract

Background: Low staffing levels and high turnover rates are longstanding issues in long-term care (LTC) facilities that were further exacerbated by the COVID-19 pandemic. Consequently, residents and staff were disproportionately affected, with high morbidity and mortality rates. This study examines changes in staffing levels, overall and by direct care worker category, across the LTC facilities sector by ownership status in Canada before and during the pandemic. It also explores differences in facility expenditures allocated towards employee wages, benefits, and subcontracts across homes by ownership status.

Data and methods: Data were from the 2020 and 2021 Nursing and Residential Care Facility Survey, which collected information on facility characteristics, including expenses, revenue, ownership status, and staffing levels. Summary statistics and multivariate linear regression models were used to examine the association between staffing levels and ownership status, with analyses stratified by direct care worker category.

Results: On average, public LTC facilities had higher staffing levels and spent a greater proportion of their total costs on employee wages and benefits before and during the pandemic, compared with for-profit and non-profit private facilities. While the total hours of care per resident day (HPRD) increased during the pandemic, there were notable variations by region, ownership status, and direct care worker category. For example, Ontario public nursing homes provided 10% more HPRD from registered nurses during the pandemic, compared with the period before.

Interpretation: Staffing levels of direct care workers in LTC facilities, overall and separately, are associated with ownership status. Allocation of employee-related expenses also differed by ownership. Further research is needed to explore interactions between ownership status, staffing levels, and quality of care for residents.

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在COVID-19大流行之前和期间，按所有权状况划分的加拿大长期护理机构的人员配备水平和费用。

背景：人员配备水平低和人员流失率高是长期护理机构的长期问题，COVID-19大流行进一步加剧了这一问题。因此，居民和工作人员受到不成比例的影响，发病率和死亡率都很高。本研究考察了加拿大在大流行之前和期间按所有权状况划分的LTC设施部门总体和直接护理人员类别的人员配备水平变化。它还探讨了按所有权状况分配给员工工资、福利和分包合同的设施支出的差异。数据和方法：数据来自2020年和2021年护理和住宿护理设施调查，该调查收集了有关设施特征的信息，包括费用、收入、所有权状况和人员配备水平。摘要统计和多元线性回归模型用于检验人员配备水平和所有权状态之间的关系，并按直接护理人员类别进行分层分析。结果：平均而言，与营利性和非营利性私营机构相比，公共LTC设施在大流行之前和期间的人员配备水平更高，员工工资和福利支出占总成本的比例更大。虽然在大流行期间，每个居民每天的护理总时数（HPRD）有所增加，但在地区、所有权状况和直接护理人员类别方面存在显著差异。例如，与之前相比，安大略省公共疗养院在大流行期间提供的注册护士HPRD增加了10%。解释：LTC设施中直接护理工作者的人员配备水平，无论是总体上还是单独的，都与所有权状态有关。员工相关费用的分配也因所有权而异。需要进一步的研究来探索所有权状况、人员配备水平和居民护理质量之间的相互作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

4.00%

发文量

期刊介绍： Health Reports publishes original research on diverse topics related to understanding and improving the health of populations and the delivery of health care. We publish studies based on analyses of Canadian national/provincial representative surveys or Canadian national/provincial administrative databases, as well as results of international comparative health research. Health Reports encourages the sharing of methodological information among those engaged in the analysis of health surveys or administrative databases. Use of the most current data available is advised for all submissions.