Pre- vs Post-Pandemic Risk-adjusted Survival Rates in the US Hospitals

Purpose

This study aims to perform a retrospective cohort study of administrative health data to understand how care delivery performance varies across US hospitals post-COVID-19 pandemic compared to the pre-pandemic performance. We also hope to identify which factors contribute to performance changes.

Conditions

  • In-hospital Mortality
  • Non-COVID Deaths
  • Surge

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Criteria

The study cohort will include one random encounter per patient for all adult (age
≥18years) encounters. All inpatients with the Premier healthcare database (PINC-AI) and
those patients who were admitted under observation status and expired in the hospital or
those who presented acutely to the emergency department and died in the emergency
department will be considered as inpatients for the purpose of this study as per prior
precedence in including such patients.

All pediatric inpatients, skilled nursing facilities inpatients, long term acute care
inpatients, rehabilitation facility inpatients, psychiatric inpatients, hospice
inpatients, chemical dependency unit inpatients and deceased organ donor inpatients are
excluded after applying encounter level exclusion criteria from this inpatient cohort.
Application of this encounter level exclusion will also preferentially exclude any
children hospitals, skilled nursing facilities, acute long term care facilities,
psychiatry hospitals, inpatient hospices and chemical dependency units.

Study Design

Phase
Study Type
Observational
Observational Model
Cohort
Time Perspective
Retrospective

Arm Groups

ArmDescriptionAssigned Intervention
Pre-pandemic admissions Patients admitted between January 1, 2018 - February 29, 2020 with one of the following five primary diagnoses of acute myocardial infarction, stroke, heart failure, pneumonia, and chronic obstructive pulmonary disease in alignment with the Centers for Medicare and Medicaid Service's (CMS's) condition-specific mortality measures reporting
Post-pandemic admissions Patients admitted between May 1, 2022 and May 31, 2023 without a diagnosis for COVID-19 and with one of the following five primary diagnoses of acute myocardial infarction, stroke, heart failure, pneumonia, and chronic obstructive pulmonary disease in alignment with the Centers for Medicare and Medicaid Service's (CMS's) condition-specific mortality measures reporting.
  • Other: COVID-19 Surge
    Impact of COVID-19 pandemic on hospital care delivery
Pandemic admissions Patients admitted between March 1, 2020 and April 30, 2022 without a diagnosis for COVID-19 and with one of the following five primary diagnoses of acute myocardial infarction, stroke, heart failure, pneumonia, and chronic obstructive pulmonary disease in alignment with the Centers for Medicare and Medicaid Service's (CMS's) condition-specific mortality measures reporting
  • Other: COVID-19 Surge
    Impact of COVID-19 pandemic on hospital care delivery

Recruiting Locations

More Details

NCT ID
NCT06651645
Status
Active, not recruiting
Sponsor
National Institutes of Health Clinical Center (CC)