Impact of the Fall 2009 Influenza A(H1N1)pdm09 Pandemic on US Hospitals

Bibliographic Data

ID9103379
AuthorsLewis Rubinson (Office of Readiness and Response, corresponding author), Ryan Mutter (Agency for Healthcare Research and Quality), Cécile Viboud (0000-0003-3243-4711, National Institutes of Health), Nathaniel Hupert (0000-0002-7590-3680, Cornell University), Timothy Uyeki, Timothy M Uyeki (0000-0001-5338-8668, National Center for Immunization and Respiratory Diseases), Andreea A Creanga (0000-0001-5171-006X, National Center for Chronic Disease Prevention and Health Promotion), Andreea Creanga, Lyn Finelli (National Center for Immunization and Respiratory Diseases), Theodore J Iwashyna (0000-0002-4226-9310, Michigan Medicine), Brendan G Carr (0000-0002-9147-9701, Office of Readiness and Response, corresponding author), Brendan Carr, Raina M Merchant (0000-0002-9801-6881, Office of Readiness and Response, corresponding author), Raina Merchant, Devi Katikineni (Social and Scientific Systems (United States)), Frances Vaughn, Frances L Vaughn (Office of Readiness and Response, corresponding author), Carolyn M Clancy (0000-0002-0308-5535, Agency for Healthcare Research and Quality), Carolyn Clancy, Nicole Lurie (Office of Readiness and Response, corresponding author)
Year2013
Volume51
Issue3
Pages259-265
Publication date2013-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31827da8ea
PMID23295577
OpenAlexW2030911993
LanguageEN
Citations received4
References cited12

BACKGROUND: Understanding how hospitals functioned during the 2009 influenza A(H1N1)pdm09 pandemic may improve future public health emergency response, but information about its impact on US hospitals remains largely unknown. RESEARCH DESIGN: We matched hospital and emergency department (ED) discharge data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project with community-level influenza-like illness activity during each hospital's pandemic period in fall 2009 compared with a corresponding calendar baseline period. We compared inpatient mortality for sentinel conditions at high-surge versus nonsurge hospitals. RESULTS: US hospitals experienced a doubling of pneumonia and influenza ED visits during fall 2009 compared with prior years, along with an 18% increase in overall ED visits. Although no significant increase in total inpatient admissions occurred overall, approximately 10% of all study hospitals experienced high surge, associated with higher acute myocardial infarction and stroke case fatality rates. These hospitals had similar characteristics to other US hospitals except that they had higher mortality for acute cardiac illnesses before the pandemic. After adjusting for 2008 case fatality rates, the association between high-surge hospitals and increased mortality for acute myocardial infarction and stroke patients persisted. CONCLUSIONS: The fall 2009 pandemic period substantially impacted US hospitals, mostly through increased ED visits. For a small proportion of hospitals that experienced a high surge in inpatient admissions, increased mortality from selected clinical conditions was associated with both prepandemic outcomes and surge, highlighting the linkage between daily hospital operations and disaster preparedness

Acute care · Case fatality rate · Coronavirus disease 2019 (COVID-19) · Disease · Emergency department · Health care · Medical emergency · Myocardial infarction · Pandemic · Pneumonia · Public health · Stroke (engine) · Surge Capacity · Disaster Response and Management · Emergency Medicine · Epidemiology · Influenza Virus Research Studies · Internal Medicine · Medicine · Respiratory viral infections research