Community spread of COVID-19 tied to patient survival rates at area hospitals
Discovering wide variation in hospitals’ COVID-19 survival rates, researchers found that the levels of COVID-19 in the surrounding community was likely the driving factor.
High rates of COVID-19 in the county where a hospital is located appears to reduce survival rates among hospitalized patients with the virus, according to a new study from researchers in the Perelman School of Medicine and at UnitedHealth Group. These findings were published in JAMA Internal Medicine.
“We have known that individual risk factors like age and gender, comorbidities such as obesity, and whether someone is a nursing home resident, are all part of what determines whether patients have a good or bad outcome. But our research shows it also matters where a patient is admitted,” says lead investigator David Asch, director of the Center for Health Care Innovation and a professor of medicine at Penn.
The team analyzed nearly 40,000 patients with COVID-19 admitted to 955 hospitals across the nation between January 1 and June 30, 2020. They examined what proportion of those patients either died in the hospital within 30 days of being admitted or were discharged to hospice, which could also signal a likely death from the virus. They found that, on average, almost 12% of patients admitted with COVID-19 to hospitals nationwide died, but the mortality rates in the hospitals with the best outcomes was 9% compared to nearly 16% for the group of hospitals with the worst outcomes.
While this data could correlate with increased knowledge of COVID-19 and treatment for its patients, the analysis found a different, prevailing factor.
“Improvement, in general, likely comes from experience in how to manage oxygenation for these patients, as well as new treatments like dexamethasone,” Asch explains. “But what explains the variation in outcomes across hospitals and the variation in their improvement is an entirely different story. The factor most strongly associated with outcomes or their improvement, based on our data, was how much COVID-19 spread there was in the hospital’s surrounding community.”
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