Predictors of COVID-19 infection and hospitalization in group homes for individuals with intellectual and/or developmental disabilities

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.