Abstract：
BACKGROUND: More than seven million people with intellectual and/or developmental disabilities (ID/DD) live in the US and may face an elevated risk for COVID-19.
OBJECTIVE: To identify correlates of COVID-19 and related hospitalizations among people with ID/DD in group homes in Massachusetts.
METHODS: We collected data during March 1, 2020-June 30, 2020 (wave 1) and July 1, 2020-March 31, 2021 (wave 2) from the Massachusetts Department of Public Health and six organizations administering 206 group homes for 1035 residents with ID/DD. The main outcomes were COVID-19 infections and related hospitalizations. We fit multilevel Cox proportional hazards models to estimate associations with observed predictors and assess contextual home- and organizational-level effects.
RESULTS: Compared with Massachusetts residents, group home residents had a higher age-adjusted rate of COVID-19 in wave 1 (incidence rate ratio [IRR], 12.06; 95 % confidence interval [CI], 10.51-13.84) and wave 2 (IRR, 2.47; 95 % CI, 2.12-2.88) and a higher age-adjusted rate of COVID-19 hospitalizations in wave 1 (IRR, 17.64; 95 % CI, 12.59-24.70) and wave 2 (IRR, 4.95; 95 % CI, 3.23-7.60). COVID-19 infections and hospitalizations were more likely among residents aged 65+ and in group homes with 6+ resident beds and recent infection among staff and residents.
CONCLUSIONS: Aggressive efforts to decrease resident density, staff-to-resident ratios, and staff infections through efforts such as vaccination, in addition to ongoing access to personal protective equipment and COVID-19 testing, may reduce COVID-19 and related hospitalizations in people with ID/DD living in group homes.
OBJECTIVE: To identify correlates of COVID-19 and related hospitalizations among people with ID/DD in group homes in Massachusetts.
METHODS: We collected data during March 1, 2020-June 30, 2020 (wave 1) and July 1, 2020-March 31, 2021 (wave 2) from the Massachusetts Department of Public Health and six organizations administering 206 group homes for 1035 residents with ID/DD. The main outcomes were COVID-19 infections and related hospitalizations. We fit multilevel Cox proportional hazards models to estimate associations with observed predictors and assess contextual home- and organizational-level effects.
RESULTS: Compared with Massachusetts residents, group home residents had a higher age-adjusted rate of COVID-19 in wave 1 (incidence rate ratio [IRR], 12.06; 95 % confidence interval [CI], 10.51-13.84) and wave 2 (IRR, 2.47; 95 % CI, 2.12-2.88) and a higher age-adjusted rate of COVID-19 hospitalizations in wave 1 (IRR, 17.64; 95 % CI, 12.59-24.70) and wave 2 (IRR, 4.95; 95 % CI, 3.23-7.60). COVID-19 infections and hospitalizations were more likely among residents aged 65+ and in group homes with 6+ resident beds and recent infection among staff and residents.
CONCLUSIONS: Aggressive efforts to decrease resident density, staff-to-resident ratios, and staff infections through efforts such as vaccination, in addition to ongoing access to personal protective equipment and COVID-19 testing, may reduce COVID-19 and related hospitalizations in people with ID/DD living in group homes.
摘要：
背景：超过700万智力和/或发育障碍（ID/DD）的人生活在美国，可能面临COVID-19的高风险。
目的：确定马萨诸塞州团体家庭中ID/DD患者中COVID-19与相关住院的相关性。
方法：我们从马萨诸塞州公共卫生部和六个组织收集了2020年3月1日至2020年6月30日（第1波）和2020年7月1日至2021年3月31日（第2波）的数据，为1035名ID/DD居民管理206个团体房屋。主要结果是COVID-19感染和相关住院。我们拟合了多级Cox比例风险模型，以估计与观察到的预测因子的关联，并评估上下文家庭和组织层面的影响。
结果：与马萨诸塞州居民相比，家庭居民群体在第1波中的COVID-19年龄校正率较高(发病率比[IRR]，12.06；95%置信区间[CI]，10.51-13.84)和第2波(IRR，2.47；95%CI，2.12-2.88)和第1波中COVID-19住院的年龄调整率较高(IRR，17.64；95%CI，12.59-24.70）和第2波（IRR，4.95；95%CI，3.23-7.60）。在65岁以上的居民和有6张以上居民床位的集体住宅中，COVID-19感染和住院的可能性更大，工作人员和居民最近感染。
结论：积极努力降低居民密度，工作人员与居民的比率，和工作人员通过疫苗接种等努力感染，除了不断获得个人防护装备和COVID-19测试之外，可能会减少住在集体住宅中的有ID/DD的人的COVID-19和相关的住院治疗。
目的：确定马萨诸塞州团体家庭中ID/DD患者中COVID-19与相关住院的相关性。
方法：我们从马萨诸塞州公共卫生部和六个组织收集了2020年3月1日至2020年6月30日（第1波）和2020年7月1日至2021年3月31日（第2波）的数据，为1035名ID/DD居民管理206个团体房屋。主要结果是COVID-19感染和相关住院。我们拟合了多级Cox比例风险模型，以估计与观察到的预测因子的关联，并评估上下文家庭和组织层面的影响。
结果：与马萨诸塞州居民相比，家庭居民群体在第1波中的COVID-19年龄校正率较高(发病率比[IRR]，12.06；95%置信区间[CI]，10.51-13.84)和第2波(IRR，2.47；95%CI，2.12-2.88)和第1波中COVID-19住院的年龄调整率较高(IRR，17.64；95%CI，12.59-24.70）和第2波（IRR，4.95；95%CI，3.23-7.60）。在65岁以上的居民和有6张以上居民床位的集体住宅中，COVID-19感染和住院的可能性更大，工作人员和居民最近感染。
结论：积极努力降低居民密度，工作人员与居民的比率，和工作人员通过疫苗接种等努力感染，除了不断获得个人防护装备和COVID-19测试之外，可能会减少住在集体住宅中的有ID/DD的人的COVID-19和相关的住院治疗。
