AHRQ, CDC and HHS Assistant Secretary for Preparedness and Response Assess the 2009 Influenza Pandemic’s Impact

The 2009 H1N1 influenza pandemic resulted in an 18 percent surge in hospital emergency department encounters, but did not have a significant impact on overall admissions, a new study published online in Medical Care found. Ten percent of the hospitals in the study experienced a surge in admissions, and patients in those facilities had worse outcomes for heart attack and stroke during periods of the surge. These hospitals also had worse outcomes for acute cardiac illnesses before the pandemic, suggesting a link between daily hospital operations and disaster preparedness. The study, requested by HHS Secretary Kathleen Sebelius, was a collaborative effort involving AHRQ, CDC, NIH, the Office of the HHS Assistant Secretary for Preparedness and Response, and academic experts. Select to access the abstract on PubMed.®

A reprint copy is available by sending an e-mail to ahrqpubs@ahrq.hhs.gov. In addition to this study, AHRQ published a new statistical brief showing that hospital emergency department visits for influenza increased from 491,900 in 2008 to 1,281,700 in 2009 and that hospital admissions for influenza rose from 88,300 to 163,200. Select to access the statistical brief, “Emergency Department Visits and Hospital Inpatient Stays for Seasonal and 2009 H1N1 Influenza, 2008-2009.”

Impact of the Fall 2009 Influenza A(H1N1)pdm09 Pand... [Med Care. 2013] - PubMed - NCBI

Med Care. 2013 Jan 3. [Epub ahead of print]

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

Rubinson L, Mutter R, Viboud C, Hupert N, Uyeki T, Creanga A, Finelli L, Iwashyna TJ, Carr B, Merchant R, Katikineni D, Vaughn F, Clancy C, Lurie N.

Source

*Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC †Agency for Healthcare Research and Quality, Rockville, MD ‡Fogarty International Center, National Institutes of Health, Bethesda, MD §Weill Cornell Medical Center, New York, NY ∥National Center for Immunization and Respiratory Diseases ¶National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA #Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI **Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA ††Social and Scientific Systems Inc., Silver Spring, MD.

Abstract

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.