UPDATE New report captures substantial losses suffered by Pennsylvania hospitals and patients

Jan. 11—A new report released Thursday provides a dark look at how the COVID-19 pandemic impacted Pennsylvania hospitals, documenting the loss of thousands of patient lives, billions of dollars and numerous health care workers who left the industry.

The death toll was 52,311 between March 2020 through December 2022, according to the joint study from the Pennsylvania Health Care Cost Containment Council (PHC4) and The Hospital and Healthsystem Association of Pennsylvania (HAP).

Patients were hospitalized a combined 2,195,047 days, averaging 8.3 days per admission.

Staff vacancies ballooned during the pandemic. Vacancy rates averaged 30% across the commonwealth by the end of 2022 for vital positions including registered nurses, nursing support staff and medical assistants. Hospitals continue to struggle to hire physicians in primary care and specialties like radiology and neurology.

Hospitals incurred an estimated cost of $8.1 billion combined in related expenses and lost revenue. The largest cost was in staffing at $1.3 billion. Lost revenue totaled $5.3 billion caused by canceled doctor appointments and elective surgeries among many other factors.

The financial losses are likely much higher, according to Barry Buckingham, executive director, PHC4 — an independent agency created by the state Legislature in 1986. The organization was required by state law to collect pandemic-related data from hospitals but participation waned in the latter months.

"I suspect, after the disaster emergency was lifted in June of 2021, hospitals were busy 'digging out' of the pandemic. They had limited resources to complete all tasks necessary and had to make choices. Ours was one of many surveys that hospitals were asked to complete. Many hospitals simply stopped tracking the specific COVID costs and did not submit," Buckingham said.

"I do believe the COVID-19 expenses would be much higher if 100% of the hospitals and health systems had submitted," he said.

Data from the report reinforced information shared during the pandemic about vulnerable groups.

The in-hospital mortality rate was 11% but was statistically higher for senior citizens, males, white patients and those living in areas with specific poverty levels — 10% to 25%.

The hospitalization rate settled at 196.7/10,000 residents. Those age 45 and older who developed the disease, especially the elderly, were far more likely to need hospitalization as were males, Black patients and those living in areas where at least 10% of the population lives in poverty.

Patients hospitalized with COVID-19 and other medical conditions — diabetes, heart failure, respiratory failure and stroke, for example — had longer stays and higher mortality rates compared to similar patients who didn't simultaneously develop COVID-19.

Sepsis was the most glaring example. Those patients who also had COVID-19 had an in-hospital mortality rate of 23.4% and averaged 8.9 days in the hospital compared to a rate of 10.9% and 6.6 average length of stay for those without the disease.

In the report, HAP states that "thoughtful intervention" is necessary to build out the infrastructure necessary to recruit and expand the healthcare workforce.

Chris Daley, HAP's vice president of strategic communications, pointed to at least a dozen different laws adopted by the Pennsylvania General Assembly as examples of interventions that have already been accomplished. He spoke of one-time financial support for front-line workers, student loan forgiveness for nurses and expanding Telehealth and virtual supervision.

He also spoke to potential state and federal legislative initiatives that haven't been made law that could be impactful — further support of telehealth to make it easier for patients to connect with clinicians, broader access to behavioral health professionals and creating incentives for clinicians to work in health care education.

"A critical component of an effective talent pipeline is the cadre of well-qualified instructors, preceptors and others who ensure that high-quality education, training and placement are possible. Many nursing education programs, for example, report waiting lists because they don't have the instructors, preceptors, clinical or lab support they need to serve more students," Daley said.