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

NCT06651645 | Active Not Recruiting

• 1 other identifier: BD022390
• Study Type: observational
• Target: 30,000,000
• Locations: 1 country
• Sites: 1

Brief Summary

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

Keywords

In-hospital mortality; Post pandemic hospital performance; Surge; Hospital recovery; Hospital performance

Outcome Measures

Primary Outcomes (1)

• Adjusted in-hospital mortality

  Our primary outcome will be based on a composite measure of in-hospital mortality or discharge to hospice as determined by discharge status code. The primary outcome will itself be expressed as a modified standardized mortality ration (mSMR) calculated as mean-shrunken number of observed deaths or discharge to hospice divided by the expected number of deaths or discharge to hospice for a center in that post-pandemic month assuming the effects of a typical center in the pre-pandemic era.

  During hospital admission

Secondary Outcomes (1)

• Rates of potential inpatient complications (PICs)

  During hospital admission

Study Arms (3)

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

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

Interventions

COVID-19 Surge OTHER

Impact of COVID-19 pandemic on hospital care delivery

Pandemic admissions; Post-pandemic admissions

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult inpatients admitted to a hospital represented with the PINC-AI hospital database.

Sponsors & Collaborators

• National Institutes of Health Clinical Center (CC): lead

Study Sites (1)

National Institutes of Health

Bethesda, Maryland, 20892, United States

Location

Study Officials

• Maniraj Neupane, MD, Ph.D.

  Grand Island Regional Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: NIH
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Tenure Track Investigator

Study Record Dates

• First Submitted: October 18, 2024
• First Posted: October 22, 2024
• Study Start: July 30, 2024
• Primary Completion: June 30, 2025
• Study Completion: June 30, 2025
• Last Updated: April 29, 2025

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)