The Hospital Situation in Greater New York. Report of a Survey of Hospitals in New York City by the Public Health Committee of the New York Academy of Medicine.

Nowhere in this nation is the return of tuberculosis more visible or more pronounced than in New York City. Fueled by poverty, homelessness and AIDS, tuberculosis has again reached epidemic proportions. New York City is at the forefront of the battle against this advancing disease. For this reason, and because the dynamics at work in New York City are a microcosm of those same forces at work in the larger society, what transpires here often foreshadows the direction that other urban centers will take. It is in this context that our New York experience provides a valuable framework for learning and for action.

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Outcomes of COVID-19 Admissions in the New York City Public Health System and Variations by Hospitals and Boroughs During the Initial Pandemic Response

Frontiers in Public Health ◽

10.3389/fpubh.2021.570147 ◽

2021 ◽

Vol 9 ◽

Author(s):

Anant Dinesh ◽

Taha Mallick ◽

Tatiana M. Arreglado ◽

Brian L. Altonen ◽

Ryan Engdahl

Keyword(s):

Public Health ◽

New York ◽

New York City ◽

Health System ◽

York City ◽

Public Health System ◽

Public Hospitals ◽

Mortality Trends ◽

The Public ◽

Pandemic Response

Introduction: In the initial pandemic regional differences may have existed in COVID-19 hospitalizations and patient outcomes in New York City. Whether these patterns were present in public hospitals is unknown. The aim of this brief study was to investigate COVID-19 hospitalizations and outcomes in the public health system during the initial pandemic response.Methods: A retrospective review was conducted on COVID-19 admissions in New York City public hospitals during the exponential phase of the pandemic. All data were collected from an integrated electronic medical records system (Epic Health Systems, Verona, WI). Overall, 5,422 patients with at least one admission each for COVID-19 were reviewed, with a study of demographic characteristics (including age, gender, race, BMI), pregnancy status, comorbidities, facility activity, and outcomes. Data related to hospitalization and mortality trends were also collected from City of New York website. These data often involved more than one facility and/or service line resulting in more location or treatment facility counts than patients due to utilization of services at more than one location and transfers between locations and facilities.Results: Higher mortality was associated with increasing age with the highest death rate (51.9%) noted in the age group >75 years (OR 7.88, 95%CI 6.32–10.08). Comorbidities with higher mortality included diabetes (OR 1.5, 95% CI 1.33–1.70), hypertension (OR 1.62, 95% CI 1.44–1.83), cardiovascular conditions (OR 1.66, 95% CI 1.47–1.87), COPD (OR 1.86, 95% CI 1.39–2.50). It was deduced that 20% of all New York City COVID-19 positive admissions were in public health system during this timeframe. A high proportion of admissions (21.26%) and deaths (19.93%) were at Elmhurst Hospital in Queens. Bellevue and Metropolitan Hospitals had the lowest number of deaths, both in borough of Manhattan. Mortality in public hospitals in Brooklyn was 29.9%, Queens 28.1%, Manhattan 20.4%.Conclusion: Significant variations existed in COVID-19 hospitalizations and outcomes in the public health system in New York City during the initial pandemic. Although outcomes are worse with older age and those with comorbidities, variations in hospitals and boroughs outside of Manhattan are targets to investigate and strategize efforts.

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