Comparison of the Impact of COVID-19 on Veterans Affairs and Non-federal Hospitals: a Survey of Infection Prevention Specialists.

Schildhouse RJ, Gupta A, Greene MT, Fowler KE, Ratz D, Hausman MS, Saint S. Comparison of the Impact of COVID-19 on Veterans Affairs and Non-federal Hospitals: a Survey of Infection Prevention Specialists. Journal of general internal medicine. 2023 Feb 1; 38(2):450-455.

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Abstract:

BACKGROUND: As the COVID-19 pandemic evolves, it is critical to understand characteristics that have allowed US healthcare systems, including the Veterans Affairs (VA) and non-federal hospitals, to mount an effective response in the setting of limited resources and unpredictable clinical demands generated by this system shock. OBJECTIVE: To compare the impact of and response to resource shortages to both VA and non-federal healthcare systems during the COVID-19 pandemic. DESIGN: Cross-sectional national survey administered April 2021 through May 2022. PARTICIPANTS: Lead infection preventionists from VA and non-federal hospitals across the US. MAIN MEASURES: Surveys collected hospital demographic factors along with 11 questions aimed at assessing the effectiveness of the hospital''s COVID response. KEY RESULTS: The response rate was 56% (71/127) from VA and 47% (415/881) from non-federal hospitals. Compared to VA hospitals, non-federal hospitals had a larger average number of acute care (214 vs. 103 beds, p < .001) and intensive care unit (24 vs. 16, p < .001) beds. VA hospitals were more likely to report no shortages of personal protective equipment or medical supplies during the pandemic (17% vs. 9%, p = .03) and more frequently opened new units to care specifically for COVID patients (71% vs. 49%, p < .001) compared with non-federal hospitals. Non-federal hospitals more frequently experienced increased loss of staff due to resignations (76% vs. 53%, p = .001) and financial hardships stemming from the pandemic (58% vs. 7%, p < 0.001). CONCLUSIONS: In our survey-based national study, lead infection preventionists noted several distinct advantages in VA versus non-federal hospitals in their ability to expand bed capacity, retain staff, mitigate supply shortages, and avoid financial hardship. While these benefits appear to be inherent to the VA''s structure, non-federal hospitals can adapt their infrastructure to better weather future system shocks.