Study Says Quality of Nonsurgical Care Declined During 2020 COVID-19 Surges

A new analysis that studied over 19 million hospital discharges in the U.S. suggests that “the quality of nonsurgical care for non-COVID patients declined significantly during 2020 COVID-19 case surges.” CIDRAP has the news.

Researchers from the Agency for Healthcare Research and Quality (AHRQ) “evaluated care-quality indicators of 19,111,629 releases from 3,283 hospitals in 2019 and 2020.” They specifically sought out hospital admissions for patients with no COVID-19 or pneumonia diagnosis and a higher risk for “pressure ulcers and death due to heart attack, heart failure, stroke, gastrointestinal bleeding, hip fracture, and coronary-artery stent placement.” They also split each hospital-week into those with high COVID-19 admission – 15 or more per 100 beds – and low admission – less than 1 per 100 beds.

Looking at weeks 18 to 48 of 2020, 35,851 hospital-weeks (36.7%) “had low COVID-19 patient admission rates, and 8,094 (8.3%) had high rates.” During those high COVID-19 weeks, rates rose for pressure ulcers, heart failure death, and hip fracture death, with a relative change of 20-30% each. The weighted average of mortality for the care indicators also climbed 10.6% during those weeks.

The researchers theorized that the decline in care quality “may have occurred because of staff shortages, assignment of inadequately trained staff to medical floors for non-COVID patients, visitor policies limiting family support, inability to monitor and manage changes in patient status, a lack of personal protective equipment, and disrupted quality-improvement processes.”