Beware of this claim:

«A US resident in a Long-Term Care Facility (LTCF) has a median length of stay (LOS) of 5 months until death, so if they die of COVID-19 it& #39;s no big deal»

It& #39;s false.

1/n
First the definition of LTCF varies by state, but usually is "nursing facilities, assisted living facilities, adult care centers, intermediate care facilities, and/or other long-term care facilities", see #long-term-care-cases-deaths">https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/ #long-term-care-cases-deaths">https://www.kff.org/health-co... (in Notes under Additional State-level Data)

2/n
The claim of a 5-month median LOS comes from this 2010 study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945440/

There">https://www.ncbi.nlm.nih.gov/pmc/artic... are 3 flaws with this claim:

Flaw #1: this study only covers nursing facilities, and excludes all other LTCF such as assisted living facilities, adult care centers, etc

3/n
Flaw #2: this study only examines the last admission (until death) in a nursing home. That& #39;s why the "at the end of life" terminology is repeated in many places.

4/n
In other words a resident may be admitted into a nursing home, stay for a while, return home, and years later is re-admitted, until his death.

Only the second stay ("at the end of life") would be included in the statistics of this study.

5/n
Flaw #3: the median is 5 months, but the mean is 13.7 months (see table 2). If the goal is to quantify the amount of life (persons × years) potentially lost to COVID-19, the mean is what we should be looking at, not the median.

6/n
More accurate studies on the mean LOS in nursing homes (not necessarily the LOS "at the end of life") show it is around 27 months (eg. https://www.longtermcarelink.net/eldercare/nursing_home.htm">https://www.longtermcarelink.net/eldercare... claims 835 days)

7/n
Another study found that on all LTCF (not only nursing homes), the mean LOS was 28.3 months ( https://web.archive.org/web/20190406214411/https://www.ahcancal.org/ncal/facts/Documents/09%202009%20Overview%20of%20Assisted%20Living%20FINAL.pdf)

8/n">https://web.archive.org/web/20190...
And the end of the stay does not necessarily conclude with death: only 33.1% of discharges are due to death, see table 6.15.

9/n
So only 1 in 3 LTCF residents die after a mean stay of around 27-28 months.

This implies the average life expectancy of an LTCF resident, at the time of admission in the facility, is greater than 27-28 months.

10/n
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