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Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study

BACKGROUND: April 22nd, 2020, New York City (NYC) was the epicenter of the pandemic of Coronavirus disease 2019 (COVID-19) in the US with differences of death rates among its 5 boroughs. We aimed to investigate the difference in mortality associated with hospital factors (teaching versus community h...

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Autores principales: Takahashi, Mai, Egorova, Natalia N., Iwagami, Masao, Kuno, Toshiki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8826663/
https://www.ncbi.nlm.nih.gov/pubmed/35135532
http://dx.doi.org/10.1186/s12913-022-07570-w
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author Takahashi, Mai
Egorova, Natalia N.
Iwagami, Masao
Kuno, Toshiki
author_facet Takahashi, Mai
Egorova, Natalia N.
Iwagami, Masao
Kuno, Toshiki
author_sort Takahashi, Mai
collection PubMed
description BACKGROUND: April 22nd, 2020, New York City (NYC) was the epicenter of the pandemic of Coronavirus disease 2019 (COVID-19) in the US with differences of death rates among its 5 boroughs. We aimed to investigate the difference in mortality associated with hospital factors (teaching versus community hospital) in NYC. DESIGN: Retrospective cohort study. METHODS: We obtained medical records of 6509 hospitalized patients with laboratory confirmed COVID-19 from the Mount Sinai Health System including 4 teaching hospitals in Manhattan and 2 community hospitals located outside of Manhattan (Queens and Brooklyn) retrospectively. Propensity score analysis using inverse probability of treatment weighting (IPTW) with stabilized weights was performed to adjust for differences in the baseline characteristics of patients initially presenting to teaching or community hospitals, and those who were transferred from community hospitals to teaching hospitals. RESULTS: Among 6509 patients, 4653 (72.6%) were admitted in teaching hospitals, 1462 (22.8%) were admitted in community hospitals, and 293 (4.6%) were originally admitted in community and then transferred into teaching hospitals. Patients in community hospitals had higher mortality (42.5%) than those in teaching hospitals (17.6%) or those transferred from community to teaching hospitals (23.5%, P < 0.001). After IPTW-adjustment, when compared to patients cared for at teaching hospitals, the hazard ratio (HR) and 95% confidence interval (CI) of mortality were as follows: community hospitals 2.47 (2.03-2.99); transfers 0.80 (0.58-1.09)). CONCLUSIONS: Patients admitted to community hospitals had higher mortality than those admitted to teaching hospitals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07570-w.
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spelling pubmed-88266632022-02-10 Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study Takahashi, Mai Egorova, Natalia N. Iwagami, Masao Kuno, Toshiki BMC Health Serv Res Research BACKGROUND: April 22nd, 2020, New York City (NYC) was the epicenter of the pandemic of Coronavirus disease 2019 (COVID-19) in the US with differences of death rates among its 5 boroughs. We aimed to investigate the difference in mortality associated with hospital factors (teaching versus community hospital) in NYC. DESIGN: Retrospective cohort study. METHODS: We obtained medical records of 6509 hospitalized patients with laboratory confirmed COVID-19 from the Mount Sinai Health System including 4 teaching hospitals in Manhattan and 2 community hospitals located outside of Manhattan (Queens and Brooklyn) retrospectively. Propensity score analysis using inverse probability of treatment weighting (IPTW) with stabilized weights was performed to adjust for differences in the baseline characteristics of patients initially presenting to teaching or community hospitals, and those who were transferred from community hospitals to teaching hospitals. RESULTS: Among 6509 patients, 4653 (72.6%) were admitted in teaching hospitals, 1462 (22.8%) were admitted in community hospitals, and 293 (4.6%) were originally admitted in community and then transferred into teaching hospitals. Patients in community hospitals had higher mortality (42.5%) than those in teaching hospitals (17.6%) or those transferred from community to teaching hospitals (23.5%, P < 0.001). After IPTW-adjustment, when compared to patients cared for at teaching hospitals, the hazard ratio (HR) and 95% confidence interval (CI) of mortality were as follows: community hospitals 2.47 (2.03-2.99); transfers 0.80 (0.58-1.09)). CONCLUSIONS: Patients admitted to community hospitals had higher mortality than those admitted to teaching hospitals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07570-w. BioMed Central 2022-02-08 /pmc/articles/PMC8826663/ /pubmed/35135532 http://dx.doi.org/10.1186/s12913-022-07570-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Takahashi, Mai
Egorova, Natalia N.
Iwagami, Masao
Kuno, Toshiki
Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study
title Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study
title_full Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study
title_fullStr Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study
title_full_unstemmed Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study
title_short Hospital factor and prognosis of COVID-19 in New York City, the United States of America: insights from a retrospective cohort study
title_sort hospital factor and prognosis of covid-19 in new york city, the united states of america: insights from a retrospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8826663/
https://www.ncbi.nlm.nih.gov/pubmed/35135532
http://dx.doi.org/10.1186/s12913-022-07570-w
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