Rural Hospitals Experienced More Patient Volume Variability Than Urban Hospitals During The COVID-19 Pandemic, 2020-21.

IF 8.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
H Joanna Jiang, Rachel Mosher Henke, Kathryn R Fingar, Lan Liang, Denis Agniel, Marc I Roemer
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Abstract

Fluctuations in patient volume during the COVID-19 pandemic may have been particularly concerning for rural hospitals. We examined hospital discharge data from the Healthcare Cost and Utilization Project State Inpatient Databases to compare data from the COVID-19 pandemic period (March 8, 2020-December 31, 2021) with data from the prepandemic period (January 1, 2017-March 7, 2020). Changes in average daily medical volume at rural hospitals showed a dose-response relationship with community COVID-19 burden, ranging from a 13.2 percent decrease in patient volume in periods of low transmission to a 16.5 percent increase in volume in periods of high transmission. Overall, about 35 percent of rural hospitals experienced fluctuations exceeding 20 percent (in either direction) in average daily total volume, in contrast to only 13 percent of urban hospitals experiencing similar magnitudes of changes. Rural hospitals with a large change in average daily volume were more likely to be smaller, government-owned, and critical access hospitals and to have significantly lower operating margins. Our findings suggest that rural hospitals may have been more vulnerable operationally and financially to volume shifts during the pandemic, which warrants attention because of the potential impact on these hospitals' long-term sustainability.

2020-21 年 COVID-19 大流行期间,农村医院比城市医院的患者量变化更大。
在 COVID-19 大流行期间,病人数量的波动可能尤其令农村医院担忧。我们研究了医疗成本与利用项目州住院病人数据库(Healthcare Cost and Utilization Project State Inpatient Databases)中的医院出院数据,将 COVID-19 大流行期间(2020 年 3 月 8 日至 2021 年 12 月 31 日)的数据与大流行前(2017 年 1 月 1 日至 2020 年 3 月 7 日)的数据进行了比较。乡镇医院日均医疗量的变化与社区 COVID-19 负担呈剂量反应关系,从低传播期患者量减少 13.2% 到高传播期患者量增加 16.5%。总体而言,约 35% 的农村医院的日均总诊疗量波动超过 20%(无论向哪个方向),相比之下,只有 13% 的城市医院经历过类似幅度的变化。日均总诊疗量变化幅度较大的农村医院更有可能是规模较小的政府所有医院和关键通道医院,其运营利润率也明显较低。我们的研究结果表明,在大流行期间,农村医院可能在运营和财务上更容易受到病例量变化的影响,这一点值得关注,因为这可能会影响这些医院的长期可持续性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health Affairs
Health Affairs 医学-卫生保健
CiteScore
15.00
自引率
2.10%
发文量
246
审稿时长
3-6 weeks
期刊介绍: Health Affairs is a prestigious journal that aims to thoroughly examine significant health policy matters both domestically and globally. Our publication is committed to addressing issues that are relevant to both the private and public sectors. We are enthusiastic about inviting private and public decision-makers to contribute their innovative ideas in a publishable format. Health Affairs seeks to incorporate various perspectives from industry, labor, government, and academia, ensuring that our readers benefit from the diverse viewpoints within the healthcare field.
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