TABLE 3.
Unadjusted and adjusted odds ratios (95% Confidence Intervals) for perceived worsening of ≥5 quality of care measures (following the onset of COVID‐19) associated with LTC survey respondent characteristics
| Characteristic | Perceived worsening of ≥5 dementia quality of care measures (vs. ≤4) | |
|---|---|---|
| Unadjusted odds ratio (95% CI) | Adjusted a odds ratio (95% CI) | |
| Respondent factors | ||
| Staff role in LTC | ||
| Administrative | 0.86 (0.40–1.84) | |
| Medical (nurse, physician) | 1.60 (0.71–3.62) | |
| Behavioural supports Ontario (ref) | 1.00 | |
| Allied healthcare/Support | 0.67 (0.34–1.29) | |
| Age | ||
| 18–34 (ref) | 1.00 | |
| 35–44 | 0.48 (0.23–1.02) | |
| 45–54 | 0.41 (0.20–0.86) | |
| ≥55 | 0.83 (0.38–1.84) | |
| Gender | ||
| Female (ref) | 1.00 | |
| Non‐female | 0.48 (0.20–1.15) | |
| Ethnicity | ||
| White (ref) | 1.00 | |
| Non‐white | 0.81 (0.45–1.48) | |
| Years of experience in LTC | ||
| <5 years | 1.59 (0.76–3.34) | 1.55 (0.68–3.56) |
| 6–10 years | 2.51 (1.18–5.34) | 2.80 (1.23–6.39) |
| 11–20 years | 1.24 (0.59–2.60) | 1.09 (0.48–2.49) |
| >20 years (ref) | 1.00 | 1.00 |
| Average # days/week providing or supporting care in LTC | ||
| ≤4 days/week | 1.25 (0.69–2.24) | |
| >4 days/week (ref) | 1.00 | |
| LTC home factors | ||
| Size (number of beds) | ||
| <100 | 1.75 (0.91–3.34) | 2.09 (1.04–4.23) |
| 100–199 (ref) | 1.00 | 1.00 |
| ≥200 | 1.17 (0.61–2.24) | 0.91 (0.42–1.96) |
| Region | ||
| Rural/Small (<30,000 population) | 1.70 (0.88–3.28) | |
| Urban (≥30,000 population) (ref) | 1.00 | |
| Ownership | ||
| Government (ref) | 1.00 | |
| Not‐for‐profit | 0.76 (0.39–1.49) | |
| For profit | 1.36 (0.70–2.66) | |
| Do not know | 0.54 (0.14–2.08) | |
| Ensuring adequate staffing levels since Mar 1/20 | ||
| Significantly more challenging | 2.17 (1.26–3.76) | 2.27 (1.24–4.15) |
| Somewhat more challenging/Same/Somewhat or significantly less challenging (ref) | 1.00 | 1.00 |
| Number of outbreaks | ||
| None (ref) | 1.00 | 1.00 |
| 1 | 1.16 (0.54–2.47) | 1.12 (0.47–2.67) |
| 2–3 | 1.15 (0.56–2.36) | 1.08 (0.48–2.46) |
| ≥4 | 2.85 (1.26–6.49) | 3.36 (1.29–8.73) |
| Size of (largest) outbreak among residents | ||
| No outbreak among residents (ref) | 1.00 | |
| <5 residents | 1.14 (0.54–2.40) | |
| 5–20 residents | 1.52 (0.69–3.33) | |
| >20 residents | 3.19 (1.56–6.54) | |
| Size of (largest) outbreak among staff | ||
| No outbreak among staff (ref) | 1.00 | |
| <5 staff | 0.90 (0.45–1.81) | |
| 5–20 staff | 1.71 (0.77–3.78) | |
| >20 staff | 3.01 (1.28–7.12) | |
| Level of COVID preparedness | ||
| Not at all or poorly prepared | 3.74 (1.75–8.01) | 3.34 (1.46–7.63) |
| Somewhat prepared | 2.21 (1.08–4.51) | 2.52 (1.15–5.50) |
| Well or very well prepared (ref) | 1.00 | 1.00 |
Note: Table 3 shows perceived worsening on a majority (≥5) of individual quality measures after adjusting for relevant covariates (see Supplementary Table 1 for the bivariate distribution of characteristics for this outcome). In adjusted models, staff respondents with fewer years of experience working in LTC, from smaller LTC homes, reporting greater challenges in ensuring adequate staffing since the pandemic onset, from LTC homes with a higher number of COVID‐19 outbreaks, or a relatively low level of COVID‐19 preparedness in the LTC homes were all significantly more likely to report perceived worsening of a majority of quality measures.
Abbreviations: CI, Confidence Intervals, LTC, long‐term care.
Final logistic regression model adjusted for years of experience in LTC, LTC home size, adequacy of staffing levels, number of outbreaks and level of COVID preparedness.