Higher hospital staffing tied to better COVID-19 survival

Hospitals with higher staffing see lower rates of mortality among COVID-19 inpatients, a recent study has found.

Drawing from the UnitedHealth Group’s Clinical Discovery Database, the researchers assessed the risk-standardized event rates (RSERs) in 95,915 patients across 1,398 hospitals. They obtained a mean RSER value of 10.78, which corresponds to a composite of in-patient mortality or referral to hospice care within 30 days of COVID-19 hospitalization.

Higher number of registered nurses (estimate, –0.017, 95 percent confidence interval [CI], –0.036 to 0.001) and emergency medicine physicians (estimate, –0.019, 95 percent CI, –0.037 to –0.002) were associated with a significantly lower RSER. This finding indicates that these personnel are particularly important to COVID-19 outcomes.

For-profit hospitals also showed better survival rates (estimate, –0.04, 95 percent CI, –0.088 to 0.033), while those with more beds (estimate, 0.03; 95 percent CI, 0.000–0.062) and with greater occupancy rates (estimate, 0.03, 95 percent CI, 0.01–0.049) had worse mortality.

Country-level factors also affected COVID-19 mortality rates. Hospitals in urban counties, for instance, saw significantly worse mortality rates (estimate, 0.096, 95 percent CI, 0.042–0.155).

“Based on our findings, staffing levels are key predictors of patient outcomes,” the researchers said. “While policymakers have focused on increasing bed capacity, the supply of personal protective equipment, and ventilators, emergency preparedness plans and future policies should also take into account registered nurse and emergency room physician staffing levels.”