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- Title
Exploring COVID‐19 census burdens by US hospital characteristics: Implications of quality reporting at rural and critical access hospitals.
- Authors
Ugwuowo, Ugochukwu C.; Meier, Sarah K.; Franco, Pablo Moreno; Noe, Katherine H.; Dowdy, Sean C.; Pollock, Benjamin D.
- Abstract
Purpose: By assessing longitudinal associations between COVID‐19 census burdens and hospital characteristics, such as bed size and critical access status, we can explore whether pandemic‐era hospital quality benchmarking requires risk‐adjustment or stratification for hospital‐level characteristics. Methods: We 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. We calculated weekly percentages of total adult hospital beds containing COVID‐19 patients. We 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. We 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. Findings: 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. Conclusions: US hospitals experienced similar COVID‐19 census burdens across multiple institutional characteristics. Evidence‐based inclusion of pandemic‐era outcomes in hospital quality reporting may not require significant hospital‐level risk‐adjustment or stratification, with the exception of rural or critical access hospitals, which experienced differentially greater COVID‐19 census burdens and may merit hospital‐level risk‐adjustment considerations.
- Subjects
UNITED States; HOSPITAL utilization; HEALTH services accessibility; ACCREDITATION; BENCHMARKING (Management); RURAL hospitals; RISK management in business; DESCRIPTIVE statistics; LONGITUDINAL method; SURVEYS; PSYCHOLOGICAL stress; COVID-19; COVID-19 pandemic
- Publication
Journal of Rural Health, 2024, Vol 40, Issue 3, p485
- ISSN
0890-765X
- Publication type
Article
- DOI
10.1111/jrh.12841