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

Brian L Block1, Thomas M Martin2, W John Boscardin3

  • 1Division of Pulmonary Allergy, Critical Care and Sleep Medicine, University of California, San Francisco, San Francisco, California.

Journal of Hospital Medicine
|March 18, 2021
PubMed

Insights

Higher COVID-19 patient burden in hospitals was linked to increased patient mortality. However, significant outcome variability persisted even after accounting for patient factors and hospital burden.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Health Services Research

Background:

  • Hospitals experienced varied patient surges during the COVID-19 pandemic.
  • Understanding the impact of patient volume on outcomes is crucial.

Purpose of the Study:

  • To determine if COVID-19 patient burden at hospitals correlated with patient mortality.
  • To analyze mortality rates across different levels of hospital COVID-19 admissions.

Main Methods:

  • A study of 14,226 patients with COVID-19 across 117 US hospitals.
  • COVID-19 burden calculated as admitted patients divided by hospital bed count.
  • Statistical analysis adjusted for patient age, sex, and comorbidities.

Main Results:

  • Overall in-hospital mortality was 20.9% at 5 weeks.
  • Hospital-level mortality ranged widely from 0% to 44.4%.
  • The highest quintile of COVID-19 burden showed a 1.46 adjusted odds ratio for in-hospital death compared to lower quintiles.

Conclusions:

  • Hospital COVID-19 patient burden is associated with increased mortality risk.
  • Significant variability in outcomes exists, suggesting other factors influence mortality.
  • Further research is needed to understand the drivers of outcome disparities.

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