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

Area of Science:

• Health Services Research
• Epidemiology
• Public Health

Background:

• The COVID-19 pandemic significantly impacted hospital operations and patient care due to unprecedented occupancy changes.
• Previous research on COVID-19's effect on hospital occupancy was limited by small sample sizes.

Purpose of the Study:

• To analyze the association between COVID-19 admission rates and hospital occupancy across different US regions and time periods in 2020.
• To quantify changes in inpatient and intensive care unit (ICU) occupancy relative to pre-pandemic levels.

Main Methods:

• A cross-sectional study utilizing data from the Healthcare Cost and Utilization Project State Inpatient Databases (2019-2020).
• Inclusion of 3960 nonfederal acute care hospitals across 45 US states.
• Regression analysis to compare 2020 weekly occupancy with 2019 data, categorizing COVID-19 admissions per 100 beds.

Main Results:

• Inpatient occupancy decreased by 12.7% during low COVID-19 admission weeks and increased by 7.9% during high admission weeks.
• Intensive care unit (ICU) occupancy surged by 67.8% during high COVID-19 admission weeks, with the most significant increases observed early in the pandemic.
• Occupancy for surgical patients decreased by 43.1% early in the pandemic during high COVID-19 admission weeks.

Conclusions:

• Hospital occupancy dynamics during 2020 showed significant variations based on COVID-19 admission rates, with notable strain on ICUs.
• High COVID-19 admission periods were linked to substantial reductions in surgical patient occupancy, potentially affecting care quality and hospital finances.
• The findings underscore the profound and complex impact of the pandemic on healthcare system resource allocation and operational capacity.