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. 2024 Jun 25;331(24):2129-2131.
doi: 10.1001/jama.2024.7752.

Ransomware Attacks, ED Visits and Inpatient Admissions in Targeted and Nearby Hospitals

Rahi Abouk  1 , David Powell  2
Affiliations

Ransomware Attacks, ED Visits and Inpatient Admissions in Targeted and Nearby Hospitals

Rahi Abouk et al. JAMA. .
No abstract available

Plain language summary

This case-control study analyzes disruptive ransomware attacks against hospitals in California from 2014 to 2020 and emergency department (ED) and inpatient admissions in attacked and nearby hospitals.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Powell reported receiving grants from the National Institute on Drug Abuse, grants from the US Centers for Disease Control and Prevention, and grants from the US Social Security Administration outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Ransomware Attacks and Weekly Emergency Department (ED) Visits and Inpatient Admissions in Attacked and Nearby Unattacked Hospitals in California, 2014-2020
A and B, the relative changes in ED visits and inpatient admissions (in logs) in hospitals with ransomware attacks (n = 15) compared with unattacked hospitals (n = 355). C and D, The relative changes in ED visits and inpatient admissions (in logs) in nearby unattacked hospitals (n = 17) compared with other unattacked hospitals (n = 20) in the same Hospital Service Area as the attacked hospital. Attacked facilities were excluded in the C and D analysis. Analyses are based on a 2-stage difference-in-differences regression model weighted by the number of total hospital beds. The 95% CIs are adjusted by clustering at the facility level and account for the 2-step process. Data are aggregated to the facility-week level. Inpatient admissions are defined as admissions involving at least 1 overnight stay. The number of intensive care units, coronary care unit, neonatal intensive care unit, and operating rooms (all in logs) and a binary variable indicating that the hospital was a teaching hospital were included as explanatory variables in addition to the facility and year-week fixed effects. Shaded areas indicate 95% CIs. The 2-stage difference-in-differences naturally normalizes mean pretreatment differences to 0. We only show the 8 weeks prior to the attack so the average of the displayed preperiod estimates in the figures may not be equal to 0.
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