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The presence of care homes and excess deaths during the COVID‐19 pandemic: Evidence from Italy


  • Caterina Alacevich
  • Nicolò Cavalli
  • Osea Giuntella
  • Raffaele Lagravinese
  • Francesco Moscone
  • Catia Nicodemo


This paper explores the relationship between the spatial distribution of excess deaths and the presence of care home facilities during the first wave of the COVID‐19 outbreak in Italy. Using registry‐based mortality data for Lombardy, one of the areas most severely hit by the pandemic we show that the presence of a care home in a municipality is associated with significantly higher excess death rates in the population. This effect appears to be driven by excess mortality in the elderly population of 70 years old and older. Our results are robust to controlling for the number of residents in each care home, suggesting that the presence of such facilities may have acted as one of factors contributing to the diffusion of COVID‐19 at the local level.

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  • Caterina Alacevich & Nicolò Cavalli & Osea Giuntella & Raffaele Lagravinese & Francesco Moscone & Catia Nicodemo, 2021. "The presence of care homes and excess deaths during the COVID‐19 pandemic: Evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 30(7), pages 1703-1710, July.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:7:p:1703-1710
    DOI: 10.1002/hec.4277

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    References listed on IDEAS

    1. Cronin, Christopher J. & Evans, William N., 2022. "Nursing home quality, COVID-19 deaths, and excess mortality," Journal of Health Economics, Elsevier, vol. 82(C).
    2. Bruno Arpino & Valeria Bordone & Marta Pasqualini, 2020. "No clear association emerges between intergenerational relationships and COVID-19 fatality rates from macro-level analyses," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 117(32), pages 19116-19121, August.
    3. Vandoros, Sotiris, 2020. "Excess mortality during the Covid-19 pandemic: Early evidence from England and Wales," Social Science & Medicine, Elsevier, vol. 258(C).
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    Cited by:

    1. Berta, Paolo & Bratti, Massimiliano & Fiorio, Carlo V. & Pisoni, Enrico & Verzillo, Stefano, 2021. "Administrative Border Effects in COVID-19 Related Mortality," IZA Discussion Papers 14930, Institute of Labor Economics (IZA).
    2. Bello, Piera & Rocco, Lorenzo, 2021. "Education, Information, and COVID-19 Excess Mortality," IZA Discussion Papers 14402, Institute of Labor Economics (IZA).

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