Ugwuowo, U. C., Meier, S. K., Franco, P. M., Noe, K. H., Dowdy, S. C., & Pollock, & B. D.

The Journal of Rural Health. 2024 May 1.

2024

Hospital

Hospital (HAP)

Not applicable

No

To assess longitudinal associations between COVID-19 census burdens and hospital characteristics, such as bed size and critical access status, and explore whether pandemic-era hospital quality benchmarking requires risk-adjustment or stratification for hospital-level characteristics.

Descriptive Study

The authors used hospital-level data from the US Department of Health and Human Services including weekly total hospital and COVID-19 censuses from August 2020 to August 2023 and the 2021 American Hospital Association survey. The authors calculated weekly percentages of total adult hospital beds containing COVID-19 patients. They then calculated the number of weeks each hospital spent at Extreme (≥20% of beds occupied by COVID-19 patients), High (10%–19%), Moderate (5%–9%), and Low (<5%) COVID-19 stress. The authors assessed longitudinal hospital-level COVID-19 stress, stratified by 15 hospital characteristics including joint commission accreditation, bed size, teaching status, critical access hospital status, and core-based statistical area (CBSA) rurality.

Among n = 2582 US hospitals, the median (IQR) weekly percentage of hospital capacity occupied by COVID-19 patients was 6.7%(3.6%–13.0%). 80,268/213,383 (38%) hospital-weeks experienced Low COVID-19 census stress, 28 Moderate stress, 22% High stress, and 12% Extreme stress. COVID-19 census burdens were similar across most hospital characteristics, but were significantly greater for critical access hospitals. Joint commission accreditation did not appear to be associated with differential COVID-19 census burdens.

2020-2023

https://pubmed.ncbi.nlm.nih.gov/38693658/#:~:text=COVID%2D19%20census%20burdens%20were,burdens%20across%20multiple%20institutional%20characteristics.

census, COVID-19, critical access hospital, quality, risk adjustment

Neutral