Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic

Choo, Esther K; Strehlow, Matthew; Del Rios, Marina; Oral, Evrim; Pobee, Ruth; Nugent, Andrew; Lim, Stephen; Hext, Christian; Newhall, Sarah; Ko, Diana; Chari, Srihari V; Wilson, Amy; Baugh, Joshua J; Callaway, David; Delgado, Mucio Kit; Glick, Zoe; Graulty, Christian J; Hall, Nicholas; Jemal, Abdusebur; KC, Madhav; Mahadevan, Aditya; Mehta, Milap; Meltzer, Andrew C; Pozhidayeva, Dar'ya; Resnick-Ault, Daniel; Schulz, Christian; Shen, Sam; Southerland, Lauren; Du Pont, Daniel; McCarthy, Danielle M

doi:10.1136/bmjopen-2022-067986

Cited by 3 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ICUs and delayed surgeries that required recovery in ICUs. 18,22,[38][39][40][41] Our results also suggest that Hispanic patients were less likely than White patients to be admitted to hospitals with low COVID-19 burden, mirroring evidence from September 2020 to November 2021 that hospitals disproportionately serving Black patients were more likely to experience ICU occupancy greater than 90.0%. 42 Thus, at different points in the pandemic, both Black and Hispanic patients were more likely to be admitted to capacity-strained hospitals than White patients.…”

Section: Discussionmentioning

confidence: 51%

See 1 more Smart Citation

COVID-19 Admission Rates and Changes in US Hospital Inpatient and Intensive Care Unit Occupancy

Meille,

Decker,

Owens

et al. 2023

JAMA Health Forum

View full text Add to dashboard Cite

ImportanceThe COVID-19 pandemic had unprecedented effects on hospital occupancy, with consequences for hospital operations and patient care. Previous studies of occupancy during COVID-19 have been limited to small samples of hospitals.ObjectiveTo measure the association between COVID-19 admission rates and hospital occupancy in different US areas and at different time periods during 2020.Design, Setting, and ParticipantsThis cross-sectional study used data from the Healthcare Cost and Utilization Project State Inpatient Databases (2019-2020) for patients in nonfederal acute care hospitals in 45 US states, including the District of Columbia. Data analysis was performed between September 1, 2022, and April 30, 2023.ExposuresEach hospital and week in 2020 was categorized based on the number of COVID-19 admissions per 100 beds (&lt;1 [low], 1-4.9, 5-9.9, 10-14.9, or ≥15 [high]).Main Outcomes and MeasuresThe main outcomes were inpatient and intensive care unit (ICU) occupancy. We used regression analysis to estimate the average change in occupancy for each hospital-week in 2020 relative to the same hospital week in 2019.ResultsThis study included 3960 hospitals and 54 355 916 admissions. Of the admissions in the 40 states used for race and ethnicity analyses, 15.7% were for Black patients, 12.9% were for Hispanic patients, 62.5% were for White patients, and 7.2% were for patients of other race or ethnicity; 1.7% of patients were missing these data. Weekly COVID-19 admission rates in 2020 were less than 4 per 100 beds for 63.9% of hospital-weeks and at least 10 in only 15.9% of hospital-weeks. Inpatient occupancy decreased by 12.7% (95% CI, 12.1% to 13.4%) during weeks with low COVID-19 admission rates and increased by 7.9% (95% CI, 6.8% to 9.0%) during weeks with high COVID-19 admission rates. Intensive care unit occupancy rates increased by 67.8% (95% CI, 60.5% to 75.3%) during weeks with high COVID-19 admissions. Increases in ICU occupancy were greatest when weighted to reflect the experience of Hispanic patients. Changes in occupancy were most pronounced early in the pandemic. During weeks with high COVID-19 admissions, occupancy decreased for many service lines, with occupancy by surgical patients declining by 43.1% (95% CI, 38.6% to 47.2%) early in the pandemic.Conclusions and RelevanceIn this cross-sectional study of US hospital discharges in 45 states in 2020, hospital occupancy decreased during weeks with low COVID-19 admissions and increased during weeks with high COVID-19 admissions, with the largest changes occurring early in the pandemic. These findings suggest that surges in COVID-19 strained ICUs and were associated with large decreases in the number of surgical patients. These occupancy fluctuations may have affected quality of care and hospital finances.

show abstract

Section: Discussionmentioning

confidence: 51%

“…As a result, many metropolitan hospitals converted other critical care units to ICUs and delayed surgeries that required recovery in ICUs. 18 , 22 , 38 , 39 , 40 , 41 …”

Section: Discussionmentioning

confidence: 99%

COVID-19 Admission Rates and Changes in US Hospital Inpatient and Intensive Care Unit Occupancy

Meille,

Decker,

Owens

et al. 2023

JAMA Health Forum

View full text Add to dashboard Cite

show abstract

COVID-19 and crisis-driven adoption of telemedicine

Khosla,

Gurubhagavatula

2025

Principles and Practice of Sleep Telemedicine

View full text Add to dashboard Cite

Precision emergency medicine

Strehlow,

Alvarez,

Blomkalns

et al. 2024

Academic Emergency Medicine

View full text Add to dashboard Cite

BackgroundPrecision health is a burgeoning scientific discipline that aims to incorporate individual variability in biological, behavioral, and social factors to develop personalized health solutions. To date, emergency medicine has not deeply engaged in the precision health movement. However, rapid advances in health technology, data science, and medical informatics offer new opportunities for emergency medicine to realize the promises of precision health.MethodsIn this article, we conceptualize precision emergency medicine as an emerging paradigm and identify key drivers of its implementation into current and future clinical practice. We acknowledge important obstacles to the specialty‐wide adoption of precision emergency medicine and offer solutions that conceive a successful path forward.ResultsPrecision emergency medicine is defined as the use of information and technology to deliver acute care effectively, efficiently, and authentically to individual patients and their communities. Key drivers and opportunities include leveraging human data, capitalizing on technology and digital tools, providing deliberate access to care, advancing population health, and reimagining provider education and roles. Overcoming challenges in equity, privacy, and cost is essential for success. We close with a call to action to proactively incorporate precision health into the clinical practice of emergency medicine, the training of future emergency physicians, and the research agenda of the specialty.ConclusionsPrecision emergency medicine leverages new technology and data‐driven artificial intelligence to advance diagnostic testing, individualize patient care plans and therapeutics, and strategically refine the convergence of the health system and the community.

show abstract

Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic

Cited by 3 publications

References 26 publications

COVID-19 Admission Rates and Changes in US Hospital Inpatient and Intensive Care Unit Occupancy

COVID-19 Admission Rates and Changes in US Hospital Inpatient and Intensive Care Unit Occupancy

COVID-19 and crisis-driven adoption of telemedicine

Precision emergency medicine

Contact Info

Product

Resources

About