Before & after: the impact of the Covid-19 pandemic on the sustainability of nursing homes

The work we propose is part of the subject “Effect of the Covid-19 pandemic on long-term care” and results from a research in progress, where on the first phase of the investigation, exploratory interviews were made with ten nursing home technical coordinators, which are privileged informants by their knowledge of the economic impact of Covid-19 on the sustainability of social sector institutions (all approached nursing homes have cooperation agreements with Social Security). In the second phase of the study, questionnaires will be applied to several nursing homes in Portugal in order to assess the economic impact brought by the pandemic on the costs and revenues of these organizations, also seeking to analyze the pre and post pandemic profile of the elderly and families that formalize registrations in Structures Homes for the Elderly / Nursing Homes. The data from the exploratory interviews revealed that, compared to the prepandemic period, there was a decrease in the demand for the nursing homes social response, justified by the fear of outbreaks of covid-19 and the impossibility of making visits and outside trips. The analysis of the interviews also made it possible to identify a change in the clinical profile of candidates who have a greater degree of dependence and different associated comorbidities, which has an impact on the necessary human resources and on the expenses of organizations. At the same time, there are profiles of citizens with low incomes (social pensions) and unable to receive support and / or family contributions (often justified by economic insufficiency and unemployment). These perspectives highlight the increased concern of social economic institutions in their viability and financial health. The current pandemic has also required changes in the structure and financial management of social institutions, reflected in increased costs. Diverse issues such as the hiring of more human resources and team reorganizations, the use of diversified Personal Protective Equipment (PPE) and medical items, implied a significant increase in health care expenses, while there were also revenue shortfalls (e.g. closing of other social responses integrated in the institutions, reduction in the co-payment of service users, extra-deal vacancies available).