Organization and response to covid-19 of municipal health and social care of older people - impact on mortality and health care utilization in Region Stockholm (Betydelsen av kommuners olika organisation av äldreomsorg och äldrevård och deras åtgärder mot covid-19 för dödlighet och vårdutnyttjande bland äldre personer i Region Stockholm)

The covid-19 pandemic has been particularly severe in Region Stockholm. Most deaths (87.5%) have occurred to persons aged 70+, particularly in residential nursing homes. The average death rate varies from 2.5/10,000 in Norrtälje to 9.7/10,000 in Södertälje. Since 2006, Norrtälje municipality has an integrated care organization with a joint health and social care board with the municipality and Region Stockholm, focusing on integrating care for older persons with complex needs. The proposed study has two parts and will be based on an on-going project, studying the impact of integrated care, and 1) analyse the response to covid-19 by municipalhealth and social care services, and 2) the impact of the covid-19 pandemic on older (aged 70+) persons' mortality and health care utilization in Norrtälje and Södertälje, other municipalities and care settings in Region Stockholm. We will use key informant interviews in health and social care services, municipal and private providers, in Norrtälje and other municipalities, on measures implemented, collaboration between health care and social services; problems encountered. Population-based individually linked register data will be analysed for mortality and health care utilization for persons aged 70+, by level of education, income level, multimorbidity, home care, home health care, and being in residential care. Knowledge is urgently needed to improve the pandemic preparedness of health and social services to protect older people. Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi