Smaller, less-resourced hospitals may have been overburdened with the sheer number of nursing home referrals during the height of the pandemic, hinting at deep health care inequality among acute care facilities.
That’s according to a study published by medical science journal Cureus, which found that at one community hospital in Connecticut, the mortality rate was 15.23% between Jan. 1 and Aug. 1 of 2020. The majority of patients who died at the 160-bed hospital – 85.18% – were admitted from nursing facilities. The mortality rate of individuals admitted from the larger community was just 3.7%.
“Nursing home referrals during the Covid-19 pandemic have placed a heavy burden upon the resources of our hospital and likely other similar hospitals,” Cureus researchers said in the study. “The lack of published data on Covid-19-related admissions from nursing facilities to acute care hospitals makes it difficult to investigate potential health disparities.”
During the reviewed timeframe, 177 patients were admitted to the hospital, 70 of whom came from nearby SNFs.
Patients transferred from a nursing facility had 12.6 times higher odds of a 30-day inpatient mortality or referral to hospice, added Cureus researchers.
According to the study, some of the adverse outcomes might have to do with small community hospitals seeing differing, more dire clinical characteristics related to Covid hospitalizations when compared to larger urban or academic acute care systems.
These characteristics include patients admitted to the smaller Connecticut hospital from the nursing homes having lower oxygen saturation of less than 94% and an altered mental status. Moreover, heart failure and diabetes were slightly more common among nursing home residents who died after being hospitalized for Covid, compared to those from nearby SNFs who survived.
Overall, there’s a scarcity of data that compares clinical outcomes of Covid among hospitals, researchers noted.
In terms of planning for nursing home referrals to hospitals, a better understanding of the clinical characteristics of Covid-related mortality in a given geographic area is much needed, the study concluded. Also, more research is needed to really understand health disparities among patients referred from SNFs, the study found, with a special focus on Covid-related admissions.
“It will also allow community hospitals to be better prepared to reduce adverse outcomes,” researchers said.
