COVID-19 Admission Rates and Changes in Care Quality in US Hospitals

• Published in: JAMA network open 2024-05, Vol.7 (5), p.e2413127-e2413127
• Main Authors: Meille, Giacomo, Owens, Pamela L, Decker, Sandra L, Selden, Thomas M, Miller, Melissa A, Perdue-Puli, Jade K, Grace, Erin N, Umscheid, Craig A, Cohen, Joel W, Valdez, R Burciaga
• Format: Article
• Language: English
• Subjects: Adult; Aged; COVID-19; COVID-19 - epidemiology; COVID-19 - mortality; COVID-19 - therapy; Cross-Sectional Studies; Female; Fractures; Health Policy; Heart failure; Hip joint; Hospital Mortality; Hospitalization - statistics & numerical data; Hospitals - statistics & numerical data; Humans; Male; Middle Aged; Mortality; Online Only; Original Investigation; Patient Admission - statistics & numerical data; Patient Admission - trends; Pressure ulcers; Quality Indicators, Health Care; Quality of Health Care - statistics & numerical data; SARS-CoV-2; United States - epidemiology
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2024.13127

Unprecedented increases in hospital occupancy rates during COVID-19 surges in 2020 caused concern over hospital care quality for patients without COVID-19. To examine changes in hospital nonsurgical care quality for patients without COVID-19 during periods of high and low COVID-19 admissions. This cross-sectional study used data from the 2019 and 2020 Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project State Inpatient Databases. Data were obtained for all nonfederal, acute care hospitals in 36 states with admissions in 2019 and 2020, and patients without a diagnosis of COVID-19 or pneumonia who were at risk for selected quality indicators were included. The data analysis was performed between January 1, 2023, and March 15, 2024. Each hospital and week in 2020 was categorized based on the number of COVID-19 admissions per 100 beds: less than 1.0, 1.0 to 4.9, 5.0 to 9.9, 10.0 to 14.9, and 15.0 or greater. The main outcomes were rates of adverse outcomes for selected quality indicators, including pressure ulcers and in-hospital mortality for acute myocardial infarction, heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and percutaneous coronary intervention. Changes in 2020 compared with 2019 were calculated for each level of the weekly COVID-19 admission rate, adjusting for case-mix and hospital-month fixed effects. Changes during weeks with high COVID-19 admissions (≥15 per 100 beds) were compared with changes during weeks with low COVID-19 admissions (