Hospital-level risk-standardized event rates worse in association with higher county-level COVID-19 case rates
WEDNESDAY, Dec. 23, 2020 (HealthDay News) — COVID-19 mortality rates decreased in U.S. hospitals during the first months of the pandemic, according to a study published online Dec. 22 in JAMA Internal Medicine.
David A. Asch, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a cohort study involving 38,517 adults admitted to 955 U.S. hospitals with COVID-19 from Jan. 1 to June 30, 2020, to identify variation in mortality rates. The authors also examined a subset of 27,801 adults who were admitted to 398 of these hospitals that treated at least 10 patients with COVID-19 during two periods (Jan. 1 to April 30, 2020, and May 1 to June 30, 2020).
The researchers found that the mean hospital-level risk-standardized event rate (RSER) of 30-day in-hospital mortality or referral to hospice was 11.8 percent for the 955 hospitals. The mean RSER was 15.65 versus 9.06 percent in the worst- versus best-performing quintiles. In all but one of the 398 hospitals, there was an improvement noted in the mean RSER, with at least a 25 percent improvement in 94 percent of the hospitals. There was a decrease observed in the overall mean RSER from 16.6 to 9.3 percent. Worse RSERs were seen in association with higher county-level COVID-19 case rates, and declines in case rates were associated with improvement in RSERs.
“The association between high community COVID-19 case loads and both worse RSERs and greater improvement in RSERs suggests hospitals do worse when they are burdened with cases and is consistent with imperatives to flatten the curve,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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