COVID-19 Mortality Disparities Among Socially Vulnerable Medicare Beneficiaries Associated With the Quality of Nurse Work Environments in U.S. Hospitals

COVID-19 mortality disparities for socially vulnerable patients, including individuals facing higher levels of poverty, housing insecurity, and limited transportation, have been linked to the quality of hospitals where they received care. Few studies have examined the specific aspects of hospitals,...

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Veröffentlicht in:Inquiry (Chicago) Jg. 61; S. 469580241284959
Hauptverfasser: Brooks Carthon, J. Margo, Muir, K. Jane, Iroegbu, Christin, Langston, Christine, Amenyedor, Kelvin, Nikpour, Jacqueline, Lasater, Karen B., Mchugh, Matthew D., Kutney-Lee, Ann
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Los Angeles, CA SAGE Publications 01.01.2024
SAGE PUBLICATIONS, INC
SAGE Publishing
Schlagworte:
Aged
Beneficiaries
Community hospitals
COVID-19
COVID-19 - mortality
Cross-Sectional Studies
Deaths
Female
Health disparities
Health planning
Healthcare Disparities
Hospital Mortality
Hospitals
Housing
Humans
Inpatient care
Job insecurity
Male
Medical personnel
Medicare
Medicare - statistics & numerical data
Mortality
Mortality rates
Nurses
Nursing
Nursing care
Nursing Staff, Hospital - statistics & numerical data
Pandemics
Patients
Polls & surveys
Poverty
Public health
Quality of care
Quality of Health Care - statistics & numerical data
SARS-CoV-2
Social Vulnerability
United States
Vulnerability
Vulnerable Populations - statistics & numerical data
Work environment
Working Conditions
United States
United States > US
COVID-19
social vulnerability
nursing
emergency planning
work environments
ISSN:0046-9580, 1945-7243, 1945-7243
Online-Zugang:Volltext
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Zusammenfassung:COVID-19 mortality disparities for socially vulnerable patients, including individuals facing higher levels of poverty, housing insecurity, and limited transportation, have been linked to the quality of hospitals where they received care. Few studies have examined the specific aspects of hospitals, such as nursing care quality, that may underlie disparate outcomes. Recent studies suggest that nursing resources in the pre-pandemic period were associated with mortality during the COVID-19 public health emergency. In this study, we examined the association between social vulnerability, the nurse work environment, and inpatient mortality among Medicare beneficiaries hospitalized with COVID-19. A cross-sectional analysis was conducted of linked survey data collected from nurses working in New York and Illinois, Medicare claims, American Hospital Association Annual Survey data, and the Social Vulnerability Index (SVI). Higher mortality rates were observed among patients in the highest quartile of social vulnerability compared to the lowest (6870 [25.8%] vs 5019 [19.1%]; P < .001). Using multivariable regression modeling, a statistically significant interaction was found between the highest SVI quartile and the nurse work environment (OR, 0.86; 95% CI, 0.76-0.98; P < .05), implying that the effect of a higher quality nurse work environment on mortality was decidedly greater for patients in the highest quartile (odds ratio = 0.86 × 0.94 = 0.80) compared to patients in the lowest quartile (OR, 0.94). Post-hoc analyses demonstrated that hundreds of COVID-19 related deaths among the most socially vulnerable patients may have been avoided if all hospitals had a high-quality nurse work environment. Strengthening the quality of nurse work environments may help to reduce health disparities and should be considered in public health emergency planning, specifically in hospitals serving socially vulnerable communities.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0046-9580
1945-7243
1945-7243
DOI:10.1177/00469580241284959