Hospital load and increased COVID-19 related mortality in Israel

Area of Science:

• Public Health
• Epidemiology
• Healthcare Management

Background:

• The rapid spread of Coronavirus disease 19 (COVID-19) has severely strained healthcare systems globally.
• Understanding the impact of hospital capacity on patient outcomes is critical for effective pandemic response.

Purpose of the Study:

• To investigate the relationship between hospital patient load and in-hospital mortality rates for COVID-19 patients.
• To determine if changes in patient population demographics account for increased mortality during high-load periods.

Main Methods:

• Analysis of hospitalization records for 22,636 COVID-19 patients in Israel from July 2020 to January 2021.
• Comparison of in-hospital mortality rates during periods of low (250-500 severely-ill patients) versus moderate-to-high (>500 severely-ill patients) patient load.
• Statistical analysis to control for potential confounding factors, including patient population characteristics.

Main Results:

• In-hospital mortality rates for COVID-19 patients significantly increased during periods of moderately heavy patient load compared to periods of lower load.
• Specifically, 14-day mortality rates were 22.1% higher (SE 3.1%) during September-October and 27.2% higher (SE 3.3%) during December-January.
• The study found no evidence that changes in the patient population's characteristics explained the increased mortality during high-load periods.

Conclusions:

• Healthcare system strain due to high patient load during COVID-19 surges is directly associated with increased in-hospital mortality.
• Effective management of hospital capacity is crucial to mitigate adverse outcomes for COVID-19 patients.
• These findings underscore the need for robust healthcare infrastructure and surge capacity planning to manage public health crises.