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10 September 2022

What long-term care interventions and policy measures have been studied during the COVID-19 pandemic? Findings from a systematic mapping review of the scientific evidence published during 2021

William Byrd , London School of Economics and Political Science , United Kingdom

Disha Patel, London School of Economics and Political Science
Joanna Marczak, London School of Economics and Political Science
Maximilian Salcher-Konrad, Austrian National Public Health Institute; London School of Economics and Political Science
Adelina Comas-Herrera, London School of Economics and Political Science

Abstract

Context: Throughout the Covid-19 pandemic, researchers have aimed to rapidly generate evidence on interventions and policy measures introduced into long-term care settings, to inform the pandemic response. In 2021, we undertook a systematic mapping review to understand which measures were prioritised for analysis during the first year of the pandemic. It was unclear if the trends identified in this previous review were reproduced during the second year of the pandemic.

Objectives: We aimed to map the international scientific evidence on interventions and policy measures implemented to mitigate the impacts of the Covid-19 pandemic on people who use and provide long-term care, published during the second year of the pandemic. Related to this, we aimed to understand if the measures prioritised for analysis in the second year of the pandemic were similar to those identified in our previous review.

Methods: We conducted a systematic mapping review of international scientific evidence to identify the range of interventions and policy measures implemented in long-term care during the Covid-19 pandemic, published during the second year of the pandemic. Studies were primarily identified from two academic databases (Ovid; Web of Science). Once we mapped the measures, we compared the trends identified to those in our previous review.

Findings: We included 337 studies from 39 countries, mostly focused on the United States, Western Europe, and Canada. This was a major increase compared to the 137 studies from 22 countries identified in our previous review. Nearly three-quarters of the studies focused on preventing/controlling Covid-19 infections. Other common types of interventions were measures to compensate for isolation policies (17%), measures to treat Covid-19 / improve access to general healthcare (17%), and measures to improve care coordination/governance (15%). Only 35 studies (10%) reported on home-based or community care, similar to the 13 (9%) identified in our previous review. A major difference between the trends identified in the two reviews was the prevalence of studies focused on vaccinations in the second year. Other differences included a greater focus in the second year on measures to compensate for isolation policies, interventions to improve the quality of care, measures to improve care coordination/governance, and visiting policies.

Limitations: We only searched two English language databases and consequently the findings may not be representative of the international literature.

Implications: During the second year of the Covid-19 pandemic, a substantial body of evidence emerged. Echoing our previous review and reflecting the context and speed with which many studies were carried out, most did not apply an analytical lens and instead provided descriptive findings only. Additionally, there were very few studies focused on home-based or community care settings. As countries assess the lessons that can be learnt from the pandemic and improve the preparedness of their long-term care systems for future pandemics and other shocks, it will be crucial for them to consider the importance of facilitating the rapid generation of robust evidence in diverse settings.

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