Care Disruption During COVID-19: a National Survey of Hospital Leaders.
J Gen Intern Med
; 38(5): 1232-1238, 2023 04.
Article
in English
| MEDLINE | ID: covidwho-2296728
ABSTRACT
BACKGROUND:
The COVID-19 pandemic caused massive disruption in usual care delivery patterns in hospitals across the USA, and highlighted long-standing inequities in health care delivery and outcomes. Its effect on hospital operations, and whether the magnitude of the effect differed for hospitals serving historically marginalized populations, is unknown.OBJECTIVE:
To investigate the perspectives of hospital leaders on the effects of COVID-19 on their facilities' operations and patient outcomes.METHODS:
A survey was administered via print and electronic means to hospital leaders at 588 randomly sampled acute-care hospitals participating in Medicare's Inpatient Prospective Payment System, fielded from November 2020 to June 2021. Summary statistics were tabulated, and responses were adjusted for sampling strategy and non-response.RESULTS:
There were 203 responses to the survey (41.6%), with 20.7% of respondents representing safety-net hospitals and 19.7% representing high-minority hospitals. Over three-quarters of hospitals reported COVID testing shortages, about two-thirds reported staffing shortages, and 78.8% repurposed hospital spaces to intensive care units, with a slightly higher proportion of high-minority hospitals reporting these effects. About half of respondents felt that non-COVID inpatients received worsened quality or outcomes during peak COVID surges, and almost two-thirds reported worsened quality or outcomes for outpatient non-COVID patients as well, with few differences by hospital safety-net or minority status. Over 80% of hospitals participated in alternative payment models prior to COVID, and a third of these reported decreasing these efforts due to the pandemic, with no differences between safety-net and high-minority hospitals.CONCLUSIONS:
COVID-19 significantly disrupted the operations of hospitals across the USA, with hospitals serving patients in poverty and racial and ethnic minorities reporting relatively similar care disruption as non-safety-net and lower-minority hospitals.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19 Testing
/
COVID-19
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Gen Intern Med
Journal subject:
Internal Medicine
Year:
2023
Document Type:
Article
Affiliation country:
S11606-022-08002-5
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