The Impact of Federal COVID-19 Provider Relief Funds on Patients, Hospitals, and Disparities

联邦 COVID-19 提供者救济基金对患者、医院和差异的影响

• 批准号: 10673511
• 负责人: Jason David Buxbaum
• 金额: $ 4.31万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2024-07-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10673511
• 关键词: Impact; Federal; COVID; 19; Provider

Project Summary/Abstract The outbreak of COVID-19 in 2020 imposed extreme demands on the US medical system. Congress responded with $178 billion in emergency relief to be shared among hospitals, physicians, and other providers. However, little is known about the impact of these funds on inpatient capacity, patient experience, patient mortality, or closure and consolidation. The impact of funding on racial/ethnic disparities is also unknown. I aim to address these gaps in knowledge. I propose to exploit a natural experiment made possible by how the US Department of Health and Human Services (HHS) distributed $34 billion in COVID-19 relief funds for hospitals. These funds, awarded to safety- net hospitals and hospitals with high numbers of COVID-19 cases early in the pandemic, were allocated using formulas with inflexible thresholds. Using regression discontinuity methods, I will compare outcomes at hospitals barely missing the criteria for funding with hospitals barely surpassing the criteria for funding. I will extend the common regression discontinuity design to accommodate the multi-variable, multi-cutoff formulas adopted by HHS for fund allocation. Results will have broad policy relevance in several respects, irrespective of whether I detect statistically significant effects. Findings will speak to the advisability of channeling finite resource to the acute care system when public health conditions next overwhelm capacity. Evaluation of this relationship between funding and capacity will speak directly to AHRQ’s focus on improving safety, quality, and access. The research will increase understanding of the trade-off between quality and affordability, which can in turn inform decisions around cost containment. In addition, the research will contribute to understanding of the relationship between hospital funding, hospital closures, and competition-reducing consolidation. Closures and consolidation represent perennial challenge to access and affordability – areas of key focus for AHRQ. Finally, findings will speak to the extent that politically viable, “color-blind” policies can reduce disparities across racial and ethnic lines. In so doing, findings can inform the tactics used by policymakers and advocates to reduce healthcare inequities

项目摘要/摘要 Covid-19于2020年对美国国会提出了极端需求 回应了1780亿美元的紧急救济，将在医院，医师和其他提供者之间分享。 但是，对于资金对住院容量，患者经验，患者的影响知之甚少 死亡率或封闭和巩固。 旨在解决知识中的这些差距。 我建议利用美国卫生和人类部如何进行的自然实验 Services（HHS）在Covid-19中分配了340亿美元的医院救济资金。 在大流行的早期，净峰值和高数量的共同Casses的净峰值和霍斯峰被分配 使用回归不连续方法的不灵活阈值的公式，我将在 医院的酒吧几乎没有缺少用于医院资金的标准，几乎没有超过资金标准。 扩展常见的回归不连续设计，以适应多变量的多切法公式 由HHS通过用于资金分配。 结果将在几个重新选择中扩大政策的重新结合，而不管我是否从统计上检测到 重大影响将与将有限资源引入急性护理系统的建议 当公共卫生条件下一个压倒性的卡皮斯时。 能力将直接表达AHRQ的重点，以提高安全性，质量和访问。 提高对质量和负担能力之间权衡的理解，这反过来可以为决策提供信息 成本围绕成本。 封闭和合并。 代表访问和负担能力的多年生挑战 - 最终，AHRQ的关键领域 在某种程度上说，政治上的“色盲”政策可以减少罗斯尔和种族之间的差异 线条。 不平等