Study: Quality for nonsurgical care declined for non-COVID patients during 2020 COVID-19 surges

Editor's Note

A recent analysis from the Agency for Healthcare Research and Quality (AHRQ) of over 19 million hospital discharges in the US showed a significant decline in the quality of nonsurgical care for non-COVID-19 patients during the 2020 COVID-19 surges, Healthcare Purchasing News May 28 reports. Specifically, the study evaluated care-quality indicators from 19,111,629 hospital releases across 3,283 hospitals in 2019 and 2020.

The focus was on non-COVID patients at higher risk for pressure ulcers, heart attack, heart failure, stroke, gastrointestinal bleeding, hip fracture, and coronary-artery stent placement. The study categorized hospital weeks into those with high COVID-19 admissions (15 or more per 100 beds) and low admissions (less than 1 per 100 beds). The findings include:

• From weeks 18 to 48 of 2020, 36.7% of hospital-weeks had low COVID-19 patient admission rates, while 8.3% experienced high rates.
• During high COVID-19 admission weeks, the incidence of pressure ulcers, heart failure deaths, and hip fracture deaths increased by 20% to 30%.
• For the same period, the weighted average mortality for care indicators rose by 10.6%.

The researchers suggest the decline in care quality may be due to staff shortages, use of inadequately trained staff, restricted family support due to visitor policies, inability to monitor patient status, lack of personal protective equipment, and disrupted quality-improvement processes.