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. 2021 Apr;16(4):211-214.
doi: 10.12788/jhm.3539.

Analysis of Hospital Resource Availability and COVID-19 Mortality Across the United States

Alexander T Janke  1 , Hao Mei  2 , Craig Rothenberg  1 , Robert D Becher  3 , Zhenqiu Lin  2 , Arjun K Venkatesh  1   2
Affiliations

Analysis of Hospital Resource Availability and COVID-19 Mortality Across the United States

Alexander T Janke et al. J Hosp Med. 2021 Apr.

Abstract

Although the impact of COVID-19 has varied greatly across the United States, there has been little assessment of hospital resources and mortality. We examine hospital resources and death counts among hospital referral regions from March 1 to July 26, 2020. This was an analysis of American Hospital Association data with COVID-19 data from the New York Times. Hospital-based resource availabilities were characterized per COVID-19 case. Death count was defined by monthly confirmed COVID-19 deaths. Geographic areas with fewer intensive care unit beds (incident rate ratio [IRR], 0.194; 95% CI, 0.076-0.491), nurses (IRR, 0.927; 95% CI, 0.888-0.967), and general medicine/surgical beds (IRR, 0.800; 95% CI, 0.696-0.920) per COVID-19 case were statistically significantly associated with an increased incidence rate of death in April 2020. This underscores the potential impact of innovative hospital capacity protocols and care models to create resource flexibility to limit system overload early in a pandemic.

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Figures

FIG
FIG
April COVID-19 Excess Deaths Estimated in Model of ICU Bed Availability. The map depicts the difference between observed and predicted death counts from COVID-19 by hospital referral region. A Poisson distribution regression model of COVID-19 death count on ICU beds per COVID-19 case was estimated, and predicted death counts were obtained via postestimation method that assumed that hospital referral regions with fewer-than-average ICU beds per case instead had the average amount nationwide in April. Abbreviation: ICU, intensive care unit.
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