Question: Follow-up question: How much “additional death” in nursing homes does this represent? How many years does one usually live in a nursing home and what is the “normal” rate of death for nursing homes? What percentage of the nursing home population dies on average every year?
Answer: Interesting question! In December, the New England Medical Journal published this short analysis, “Changes in Place of Death in the United States”. The authors find that in 2017, 21% of all deaths occurred in nursing homes (534,714 deaths in nursing homes in 2017). For more detail, see Figure 1, which I copied from the paper. Data for 2020 are limited when it comes to nursing home fatalities, both overall fatalities and those due to COVID-19. Based on what we do know, a much larger proportion of COVID-19 deaths is occurring in nursing homes (35% of all deaths) as compared with what we could consider to be the baseline (21% of all deaths). Finally, when it comes to overall mortality in nursing homes, a quick pubmed search provided a couple of articles that followed two different longitudinal cohorts of nursing home residents, one in Norway and the other in Iceland, both of which showed median survival of approximately 2.5 years (27 months and 31 months respectively). Of course, median survival depends dramatically on underlying health, age of admission, availability of home care services, and more. I’m not sure how well these data translate into the US context. In that vein, I did find some tables on nursing home residents for 2016 in the United States thanks to CDC (Figure 2). IF we were to assume that the data shared in the NEMJ article on nursing home deaths and the data shared from CDC on nursing home residents were comparable, it would seem that about 30% of nursing home and residential care residents die each year (534,714 deaths / 1,924,300 nursing and residential care residents). I’m not sure about this back of the envelope, however, as I’m not sure how residential care (e.g. assisted living) factors into the death estimates and I don’t like comparing data from two different sources.
Figure 1. Changes in Places of Death in the US
Figure 2. Nursing Home Residents in 2016
