Hospital Performance, Nursing Resources, and Health Inequities During the COVID-19 Pandemic

作者：Ann Kutney‐Lee, Daniela Golinelli, Shelli L. Feder, Kelvin Amenyedor, Karen B. Lasater, Matthew D. McHugh, J. Margo Brooks Carthon · 发表于：Nursing Research · 年份：2025 · DOI：10.1097/nnr.0000000000000821 · 被引用次数：3 · 研究领域：Disaster Response and Management、COVID-19 and healthcare impacts、COVID-19 and Mental Health

BACKGROUND: Few researchers have examined the organizational features of high-performing and low-performing hospitals for COVID-19 mortality during the pandemic, and how differences in hospital performance contributed to mortality disparities among socially vulnerable patients hospitalized with COVID-19. OBJECTIVES: Our objectives were (a) to identify high- and low-performing hospitals on COVID-19 inpatient mortality and describe their distinguishing organizational characteristics, including nursing resources, and (b) to assess whether patients admitted to high-performing hospitals differed by social vulnerability level. METHODS: This analysis used linked nurse survey, hospital, and claims data for 73,792 hospitalized older adults diagnosed with COVID-19 across 96 New York and Illinois hospitals between January 1, 2020, and December 31, 2020. A robust benchmarking approach was used to identify high- and low-performing hospitals on 30-day inpatient mortality. We computed the cumulative proportion of admissions for patients in the highest and lowest social vulnerability index quartiles to the hospitals ranked by performance. RESULTS: The average mortality rate in the high-performing hospitals was 16.2% compared to 31.5% in the low-performing hospitals. Compared to low-performing hospitals, high-performing hospitals had more favorable nurse work environments and lower patient-to-nurse ratios. About half the patients in the lowest social vulnerability quartile (least vulnerable) ...