COVID-19 pandemic hurt hospital care for non-COVID patients

The COVID-19 pandemic was bad for hospital patients even if they did not have that illness.

As admission rates swelled due to the pandemic, the odds of in-hospital death grew by 1.2 times for non-COVID-19 patients, and about 1.7 times for all patients, as physicians and clinical staff struggled under the workload.

Weiwei Chen, PhD
_{Matt Yung, Kennesaw State University}

“Multiple factors contributed to the increase in mortality rates with COVID spikes, but resource constraints seem to be the main reason, which includes, for example, healthcare worker burnout, staff shortages and reduced bed space,” study author Weiwei Chen, PhD, said in a news release. Chen is an assistant professor of economics at Kennesaw State University and her study, “COVID-19 Surges and Hospital Outcomes in the United States,” was published in The American Journal of Managed Care.

Delay in care may have contributed to those results. Non-COVID-19 patients hospitalized during the pandemic might have been sicker due to delaying or foregoing care in the early days of the pandemic, the study said.

During the pandemic, Chen began researching the effects of COVID-19 surges on hospital outcomes, particularly for non-COVID-19 patients. The data came from the COVID-19 Research Database, the U.S. Census, and other sources, with a set of more than 570 hospitals and a total of more than 1 million admissions in 2019 and 2020.

In short: “The pandemic was associated with higher odds of mortality,” for all patients. The odds grew worse when COVID-19 cases peaked, and for patients aged 45 years and older, and those with septicemia or pneumonia, the study said.

For all patients, the study found the percentage of in-hospital deaths grew from 1.7% in 2019 to 2.7% in 2020. Combined with discharges to hospice, the mortality measure rose from 3.1% in 2019 to 4.3% in 2020, the study said.

In the two-year period, rates of discharge to skilled nursing facilities dropped from 9.2% in 2019 to 7.7% in 2020, while discharges to home care increased from 10.2% in 2019 to 11.8% in 2020. The latter figure shows the promise of home health care as an alternative care option during the pandemic, according to the study.

“A major implication is that it is going to be very important to monitor patient outcomes at hospitals during pandemics in real time, even though it may be very difficult,” Chen said. “That is the best way to ensure the best possible patient outcomes.”

The study noted the data from the insurance claims database may not be nationally representative, and some patient characteristics, such as race, ethnicity, and payer type, wer not available.