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. 2021 Apr;16(4):215-218.
doi: 10.12788/jhm.3612.

Variation in COVID-19 Mortality Across 117 US Hospitals in High- and Low-Burden Settings

Brian L Block  1 , Thomas M Martin  2 , W John Boscardin  3 , Kenneth E Covinsky  3 , Michele Mourad  4 , Lissy L Hu  2 , Alexander K Smith  3
Affiliations

Variation in COVID-19 Mortality Across 117 US Hospitals in High- and Low-Burden Settings

Brian L Block et al. J Hosp Med. 2021 Apr.

Abstract

Some hospitals have faced a surge of patients with COVID-19, while others have not. We assessed whether COVID-19 burden (number of patients with COVID-19 admitted during April 2020 divided by hospital certified bed count) was associated with mortality in a large sample of US hospitals. Our study population included 14,226 patients with COVID-19 (median age 66 years, 45.2% women) at 117 hospitals, of whom 20.9% had died at 5 weeks of follow-up. At the hospital level, the observed mortality ranged from 0% to 44.4%. After adjustment for age, sex, and comorbidities, the adjusted odds ratio for in-hospital death in the highest quintile of burden was 1.46 (95% CI, 1.07-2.00) compared to all other quintiles. Still, there was large variability in outcomes, even among hospitals with a similar level of COVID-19 burden and after adjusting for age, sex, and comorbidities.

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Figures

FIG
FIG
In-Hospital Mortality Rates for Patients With COVID-19 at 117 US Hospitals. (A) The caterpillar plot presents the in-hospital mortality rate for patients with COVID-19 at each of the study hospitals adjusted for age, sex, and comorbidities. The y-axis represents in-hospital mortality. Hospitals are arrayed along the x-axis, ordered by adjusted mortality (point estimate with error bars representing 95% CI). The solid line depicts the adjusted mortality for the entire sample. (B) The caterpillar plot groups the same 117 hospitals by quintile of COVID-19 burden and orders hospitals by adjusted mortality within each group.
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