Project details
Lessons from the pandemic: COVID-19 in long-term care facilities in Bremen
Description
The COVID-19 pandemic had a significant impact on long-term care facilities worldwide. In Germany, a total of 930,970 people received inpatient care in 2021, more than 95 % of whom were over 60 years old (Destatis, 2025). Although long-term care residents account for only about 1 % of the total population in Germany, they made up approximately 29 % of all COVID-19 deaths during the first wave of the pandemic (Destatis, 2024; Rocard, Sillitti & Llena-Nozal, 2021). The high vulnerability of elderly and multimorbid people as well as structural challenges – such as close social contacts and limited human resources – made it difficult to implement effective infection control measures and contributed significantly to the high mortality rates. The specific factors that facilitated infections and deaths in these facilities, as well as the practical challenges in crisis management, remain insufficiently researched.
To explore these questions in greater depth, this study follows a mixed-methods approach. a) Officially reported data from long-term care facilities, collected under the German Infection Protection Act, will be statistically analyzed to identify factors associated with increased infection and mortality rates. Hierarchical models will be applied, taking into account individual, facility-level, and population-level determinants. b) In addition, guided interviews will be conducted with individuals who have taken on responsibility in long-term care during the pandemic or were involved in crisis management. The aim is to gain insights into crisis management, communication with health authorities, and the challenges of implementing infection control measures.
By integrating both analytical approaches, comprehensive findings will be generated to support recommendations for managing future pandemics in care facilities.
Literature:
Rocard, E., Sillitti, P., & Llena-Nozal, A. (2021). COVID-19 in long-term care: Impact, policy responses and challenges. OECD Health Working Papers, 131. OECD Publishing, Paris.
German Federal Statistical Office (Destatis). (2024). Population in brief (territory on 15 May 2022): Persons: Age (10-year age bands). Retrieved from https://ergebnisse.zensus2022.de/datenbank/online/url/2e784a2e
German Federal Statistical Office (Destatis). (2025). Persons in need of long-term care (residential care): Germany, reference date, sex, age groups. Retrieved from https://www-genesis.destatis.de/datenbank/online/url/a92c6881
Further information
Lizzi Müller genannt Schumacher is a research assistant at the Bremen Health Department and works as a visiting researcher in the IPP's Health Services Research Department.