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Effect of Coronavirus Disease 2019 (Covid-19), a Nationwide Mass Casualty Disaster on Intensive Care Units: Clinical Outcomes and Associated Cost-of-Care

Published online by Cambridge University Press:  15 June 2022

Allison M. Henning Open the ORCID record for Allison M. Henning [Opens in a new window] ,
Neal J. Thomas ,
Duane C. Williams ,
David M. Shore ,
Michelle E. Memmi  and
Li Wang
Allison M. Henning*
Affiliation:
Department of Internal Medicine and Pediatrics, Penn State MS Hershey Medical Center, Hershey, PA, USA
Neal J. Thomas
Affiliation:
Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, Hershey, Pennsylvania
Duane C. Williams
Affiliation:
Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, Hershey, Pennsylvania
David M. Shore
Affiliation:
Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Penn State MS Hershey Medical Center, Hershey, PA, USA
Michelle E. Memmi
Affiliation:
Department of Quality Systems Improvement, Penn State MS Hershey Medical Center, Hershey, PA, USA
Li Wang
Affiliation:
Department of Public Health Sciences, Penn State College of Medicine, Hershey, USA
*
Corresponding author: Allison Henning, Email: ahenning1@pennstatehealth.psu.edu.
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Abstract

Objective:

The COVID-19 pandemic resulted in millions of deaths worldwide and is considered a significant mass-casualty disaster (MCD). The surge of patients and scarcity of resources negatively impacted hospitals, patients and medical practice. We hypothesized ICUs during this MCD had a higher acuity of illness, and subsequently had increased lengths of stay (LOS), complication rates, death rates and costs of care. The purpose of this study was to investigate those outcomes.

Methods:

This was a multicenter, retrospective study that compared intensive care admissions in 2020 to those in 2019 to evaluate patient outcomes and cost of care. Data were obtained from the Vizient Clinical Data Base/Resource Manager (Vizient Inc., Irvine, Texas, USA).

Results:

Data included the number of ICU admissions, patient outcomes, case mix index and summary of cost reports. Quality outcomes were also collected, and a total of 1304981 patients from 333 hospitals were included. For all medical centers, there was a significant increase in LOS index, ICU LOS, complication rate, case mix index, total cost, and direct cost index.

Conclusion:

The MCD caused by COVID-19 was associated with increased adverse outcomes and cost-of-care for ICU patients.

Keywords

disaster responsepatient outcomescost-of-caremass casualty outcomeshealth economic outcomes
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e249
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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