The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England

Abstract Background As the impact of the SARS-CoV-2 pandemic extends into 2023 and beyond, the treatment and outcomes of infected patients continues to evolve. Unlike earlier in the pandemic there are now further infectious disease pressures placed on hospitals, which influence patient care and tria...

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Main Authors: Jonathon Mellor, Owen Jones, Thomas Ward
Format: Article
Language:English
Published: Springer 2024-10-01
Series:Journal of Epidemiology and Global Health
Subjects:
Online Access:https://doi.org/10.1007/s44197-024-00310-9
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author Jonathon Mellor
Owen Jones
Thomas Ward
author_facet Jonathon Mellor
Owen Jones
Thomas Ward
author_sort Jonathon Mellor
collection DOAJ
description Abstract Background As the impact of the SARS-CoV-2 pandemic extends into 2023 and beyond, the treatment and outcomes of infected patients continues to evolve. Unlike earlier in the pandemic there are now further infectious disease pressures placed on hospitals, which influence patient care and triage decisions. Methods The manuscript uses individual patient records linked with associated hospital management information of system pressure characteristics to attribute COVID-19 hospitalisation fatality risks (HFR) to patients and hospitals, using generalised additive mixed effects models. Results Between 01 September 2022 and 09 October 2023, the COVID-19 hospitalisation fatality risk in England was estimated as 12.71% (95% confidence interval (CI) 12.53%, 12.88%). Staff absences had  an adjusted odds ratio of 1.038 (95% CI 1.017, 1.060) associated with the HFR when accounting for patient and hospital characteristics. Interpretation This observational research presents evidence that a range of local hospital effects can have a meaningful impact on the risk of death from COVID-19 once hospitalised and should be accounted for when reporting estimates. We show that both the patient case mix and hospital pressures impact estimates of patient outcomes.
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spelling doaj-art-73e5756d15e14bd4bb1d1f85795f59eb2025-08-20T01:57:11ZengSpringerJournal of Epidemiology and Global Health2210-60142024-10-011441579159010.1007/s44197-024-00310-9The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in EnglandJonathon Mellor0Owen Jones1Thomas Ward2UK Health Security AgencyUK Health Security AgencyUK Health Security AgencyAbstract Background As the impact of the SARS-CoV-2 pandemic extends into 2023 and beyond, the treatment and outcomes of infected patients continues to evolve. Unlike earlier in the pandemic there are now further infectious disease pressures placed on hospitals, which influence patient care and triage decisions. Methods The manuscript uses individual patient records linked with associated hospital management information of system pressure characteristics to attribute COVID-19 hospitalisation fatality risks (HFR) to patients and hospitals, using generalised additive mixed effects models. Results Between 01 September 2022 and 09 October 2023, the COVID-19 hospitalisation fatality risk in England was estimated as 12.71% (95% confidence interval (CI) 12.53%, 12.88%). Staff absences had  an adjusted odds ratio of 1.038 (95% CI 1.017, 1.060) associated with the HFR when accounting for patient and hospital characteristics. Interpretation This observational research presents evidence that a range of local hospital effects can have a meaningful impact on the risk of death from COVID-19 once hospitalised and should be accounted for when reporting estimates. We show that both the patient case mix and hospital pressures impact estimates of patient outcomes.https://doi.org/10.1007/s44197-024-00310-9Hospitalisation fatality riskSARS-CoV-2Hospital strainSeverity estimate
spellingShingle Jonathon Mellor
Owen Jones
Thomas Ward
The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England
Journal of Epidemiology and Global Health
Hospitalisation fatality risk
SARS-CoV-2
Hospital strain
Severity estimate
title The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England
title_full The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England
title_fullStr The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England
title_full_unstemmed The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England
title_short The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England
title_sort impact of healthcare pressures on the covid 19 hospitalisation fatality risk in england
topic Hospitalisation fatality risk
SARS-CoV-2
Hospital strain
Severity estimate
url https://doi.org/10.1007/s44197-024-00310-9
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