January 2021
(Revised July 2021)*
PA Health Care Cost cae . . .
Containment Council COVID-19 Hospitalizations in Pennsylvania— March to June 2020

. This research brief examines COVID-19 hospitalizations for patients of all ages, Pennsylvania

     

residents and non-residents, who were discharged from Pennsylvania's acute care hospitals

from March through June 2020. As these hospitalizations occurred during the first four

Raver
HN

months of the COVID-19 pandemic, the results form a basis for future analysis and

comparison as subsequent data becomes available.

 

@ There were 19,177 COVID-19 hospitalizations in Pennsylvania between March and June 2020.

@ These patients spent a total of 168,511 days in the hospital. The average length of stay was 8.8 days.
17.4% of the patients stayed 14 days or longer.

@ 15.7% of the patients required mechanical ventilation.

@ 16.3% of the patients died during their hospitalization.

COVID-19 Hospitalizations, March 2020 — June 2020

Number of Hospitalizations and In-Hospital Mortality Rate by Discharge Month

 

10,000 25%
iad Number of Hospitalizations
=@==|n-Hospital Mortality Rate
@ The number of
20% hospitalizations
was at its highest
in April.

8,000

6,000 15%

® The in-hospital
mortality rate
peaked in April.

4,000 10%

In-Hospital Mortality Rate

® Both the number
of hospitalizations
and the in-hospital
5% mortality rates
declined from their
highest point in

ye 3,166 April to June.
0%

Number of Hospitalizations

2,000

March 2020 April 2020 May 2020 June 2020

Discharge Month

 

* This brief was revised to reflect a correction in the hospitalization rate reported on page 2 for the 18-24 years age category.

rr Pennsylvania Health Care Cost Containment Council 1
COVID-19 Hospitalizations, March 2020 — June 2020

by Patient Characteristics

 

® Hospitalization rates are higher for older residents, especially ages 55 and older; male residents; Hispanic
residents and Black, non-Hispanic residents; and residents living in high poverty areas (where 25% or more
of the population lives in poverty).

@ In-hospital mortality rates are higher for older patients, especially ages 65 and older; male patients;
White, non-Hispanic patients; and patients living in low poverty areas (where less than 10% of the
population lives in poverty).

@ Average length of stay is longer for patients age 55 years to 74 years; male patients; and Black, non-
Hispanic patients.

® Mechanical ventilation rates are higher for patients age 55 years to 74 years; male patients; and Asian,
non-Hispanic and Black, non-Hispanic patients.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hospitalization . Average Length .
. — Rate per Number of In Hospital of Hospital Mechanical
Patient Characteristic sa pe ge Mortality Ventilation
10,000 PA__| Hospitalizations Rate Stay Rate
Residents (in days)
Less than 18 years 0.6" 195 NR 6.2" 9.7%"
18-24 years 2.9° 330 NR 5.2° 7.6%
25-34 years 5.4° 956 1.4%" 6.2" 5.6%"
35-44 years 8.8" 1,384 3.0%" 7.9 10.9%"
Age 45-54 years 14.3 2,373 8.2%" 8.8 15.6%
55-64 years 20.8" 3,860 12.3%" 9.3" 19.2%"
65-74 years 28.9" 4,045 19.7%" 10.1° 22.1%"
75-84 years 46.3" 3,420 24.8%" 8.8 16.7%
85 years or more 76.6" 2,614 28.2%" 7.3" 6.8%
Female 13.6" 9,144 14.3%" 8.3" 13.0%"
Sex
Male 15.4" 10,033 18.2%" 9.2° 18.1%"
Asian, non-Hispanic 11.0° 543 15.7% 8.6 19.7%"
Race and | Black, non-Hispanic 43.1" 6,130 15.3% 9.4" 17.5%
Ethnicityt) Hispanic 22.6" 2,345 9.7%" 8.0° 14.2%"
White, non-Hispanic 8.7" 8,801 19.1%" 8.6 14.5%"
Less than 10% 10.5" 6,865 17.9%" 8.6 15.4%
ren 10% to less than 25% 13.9" 7,621 17.0% 8.9 16.3%
25% or more 37.4" 4,691 13.0%" 8.9 15.1%
Statewide 14.5 19,177 16.3% 8.8 15.7%

 

 

 

 

 

 

 

 

NR: Not reported due to low in-hospital mortality volume.
“Statistically significant difference (at a=0.05) compared to the rest of the state.
Tt Low volume categories are not displayed; therefore, row counts do not add to the statewide total.

rr Pennsylvania Health Care Cost Containment Council 2

 
Hospitalizations related to COVID-19 versus Influenza (Flu)

Number of Hospitalizations and In-Hospital Mortality Rate

 

25,000 — 20%
liad COVID-19 Hospitalizations @ The number of COVID-19

16.3% i Influenza Hospitalizations hospitalizations during the
=@==/n-Hospital Mortality Rate four months from March —
June 2020 (19,177) was
49.4% higher than the
average annual number of
influenza hospital stays
from 2017 to 2020 (12,839).

20,000 16%

15,000 12%

10,000 8%
® The in-hospital mortality
rate for COVID-19

4% hospitalizations (16.3%) was
459.7% higher than the
average in-hospital

— SSS es 0% mortality rate for influenza
MeO. 2017 2018 2019 2020 hospital stays from 2017 to

2020 (2.9%).

Number of Hospitalizations
In-Hospital Mortality Rate

5,000

 

ea)

 

COVID-19 Influenza*

“Annual timeframes for influenza were defined as state fiscal years (July — June). Multiple years were used in this
analysis since influenza seasons tend to vary from year to year. On average, 98.7% of influenza hospitalizations in the
years 2017 through 2020 occurred during the period from October — May each fiscal year.

COVID-19 Hospitalizations, March 2020 — June 2020

by Patient Age and Payer

 

Under 18 yrs

Self-Pay Other
™~N
1.0%

@ Over half (52.6%) 2.2%
of COVID-19
hospitalizations
were for patients Medicaid
65 years and 18.3%
older.

      

® Medicare was the Medicare
payer for 52.8% 52.8%
of COVID-19

oo Commercial
hospitalizations - 23.9%

the largest
percentage
among the payer
groups.

Note: Pie chart percentages may not add to 100% due to rounding.

rr Pennsylvania Health Care Cost Containment Council 3

 
COVID-19 Hospitalization Rate per 10,000 County Residents, March 2020 — June 2020

 

Hospitalization rate per 10,000 residents

0.0 11.0 22.0 33.1 44.1

 

 

 

 

 

 

 

 

 

Susquehanna
rs Ere
Ei Seoke loge tadf,
v; u
Wayne
B55)
©
é Apne | ackawann caps
Mercer Lycoming ee 7 5
2.7 Clintor Al .
3.4
ayo Luzerne
effet: ‘olumbi 16.3 Vionroe
Fee Clearfield r 8 me
Dari Union
Butler A 1.3 cone 33 connor
. rmstrong . ae
Beaver 46 Snyder Ndrthumberlan
5.7 ai 3.7 as Schuylkill
Ingiane 3.2 fened
. fEfinJuniata 20.4
Allegheny Cambria Blair 6.1
28) 0.8 Perry Berks
32 Dauphir \_ebanon 15.9 3ucks
Westmoreland Huntingdon ae 117 16.7
Washington 5.1 jlontgo
L.4 Cumberland Yo poi
Be Lancaster
alles)
bk Bedford Chester .
Fayette . Franklin 12.2 hiladelphie
a ily) t 6 Adams York 44.1
x 3.8 4.6

 

Statewide, there were 14.5 COVID-19 hospitalizations per 10,000 Pennsylvania residents from March 2020

to June 2020. The map indicates rates of hospitalization were higher in eastern PA counties than elsewhere

across the state during this period. Higher rates for some counties might also reflect larger numbers of

residents with high-risk characteristics (e.g., factors related to age, race/ethnicity and poverty levels).

County rates were not adjusted for these population differences so that important effects of these patient

characteristics were not masked by such adjustment. Population-based rates might change as newer data

becomes available.
eT

About PHC4

Created by the PA General Assembly in 1986, the PA Health Care Cost Containment Council (PHC4) is an independent state agency
charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care
in the state. Today, PHC4 is a recognized national leader in public health care reporting. PHC4 is governed by a board of directors
representing business, labor, consumers, health care providers, insurers, health economists and state government.

Joe Martin, Executive Director
225 Market Street, Suite 400
Harrisburg, PA 17101
717-232-6787 - www.phc4.org

TD
Notes about this Brief:

e COVID-19 hospitalizations included all admissions where COVID-19 was the principal diagnosis (primary reason for
the hospital stay) or a secondary condition.

e Ininstances where in-hospital mortality was examined, patients who left against medical advice or were transferred
to another acute care hospital were excluded, as were hospitalization records with an invalid discharge status.

e Hospitalization rates reported in this brief were based on Pennsylvania residents only (18,565 hospital stays or 96.8%
of all Pennsylvania COVID-19 hospitalizations) and 2019 US Census Bureau data.

e Poverty rates reported in this brief were based on 2019 US Census Bureau estimates at the patient zip code level.

PHC4 4 Pennsylvania Health Care Cost Containment Council 4
COVID-19 Hospitalizations by County, March 2020 — June 2020

Adams

Allegheny

Armstrong
Beaver
Bedford
Berks

Blair
Bradford
Bucks
Butler
Cambria
Cameron
Carbon
Centre
Chester
Clarion
Clearfield
Clinton
Columbia
Crawford
Cumberland
Dauphin
Delaware
Elk

Erie
Fayette
Forest
Franklin
Fulton
Greene
Huntingdon
Indiana

Jefferson

NR: Not reported due to low volume.

rr Pennsylvania Health Care Cost Containment Council

NR
67
22
NR
98
NR
NR
23
25
NR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Juniata 15 6.1
Lackawanna 376 17.9
Lancaster 626 11.5
Lawrence 21 2.5
Lebanon 166 11.7
Lehigh 755 20.4
Luzerne 518 16.3
Lycoming 47 4.1
McKean NR NR
Mercer 30 2.7
Mifflin NR NR
Monroe 327 19.2
Montgomery 1,654 19.9
Montour NR NR
Northampton 725 23.7
Northumberland 42 4.6
Perry 15 3.2
Philadelphia 6,983 44.1
Pike 42 75
Potter NR NR
Schuylkill 116 8.2
Snyder 15 3.7
Somerset NR NR
Sullivan NR NR
Susquehanna 28 6.9
Tioga NR NR
Union 15 3.3
Venango NR NR
Warren NR NR
Washington 29 1.4
Wayne 18 3.5
Westmoreland 68 1.9
Wyoming NR NR
York 205 4.6
5