Evidence mapPaperPMID 39323090Full record

ArticleInquiry : a journal of medical care organization, provision and financing

COVID-19 Mortality Disparities Among Socially Vulnerable Medicare Beneficiaries Associated With the Quality of Nurse Work Environments in U.S. Hospitals.

Margo Brooks Carthon, Jane Muir, Christin Iroegbu, Christine Langston, Kelvin Amenyedor, Jacqueline Nikpour, Karen B Lasater, Matthew McHugh, Ann Kutney-Lee

Abstract read
In one paragraph

Article in Inquiry : a journal of medical care organization, provision and financing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Margo Brooks CarthonUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.ORCID 0000-0002-9797-7007
Jane MuirUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Christin IroegbuUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Christine LangstonUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Kelvin AmenyedorUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Jacqueline NikpourUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Karen B LasaterUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Matthew McHughUniversity of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Ann Kutney-LeeCorporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.

Funding

ADVANCED TRAINING IN NURSING OUTCOMES RESEARCHT32NR007104 · UNIVERSITY OF PENNSYLVANIA · 1999 to 2025
$2.6M
Multilevel Panel Study of Effects of Changes in Nursing on Patient OutcomesR01NR014855 · NINR · UNIVERSITY OF PENNSYLVANIA · 2024 to 2025
$1.5M
Achieving High Quality Outcomes for Patients with Acute Respiratory Distress Syndrome: Lessons Learned from Nurses in High Performing HospitalsR01NR020471 · UNIVERSITY OF PENNSYLVANIA · 2025 to 2025
$406k
Evaluating Hospital Nurse Resources as a Driver of Outcomes Differences in Hospitals Serving High-Risk PatientsR01NR021234 · UNIVERSITY OF PENNSYLVANIA · 2025 to 2025
$406k
AHRQ HHS R01 HS028978NINR NIH HHS R01 NR014855NINR NIH HHS R01 NR020471NINR NIH HHS R01 NR021234NINR NIH HHS T32 NR007104
6 · The paper itself

Abstract

COVID-19 mortality disparities for socially vulnerable patients, including individuals facing higher levels of poverty, housing insecurity, and limited transportation, have been linked to the quality of hospitals where they received care. Few studies have examined the specific aspects of hospitals, such as nursing care quality, that may underlie disparate outcomes. Recent studies suggest that nursing resources in the pre-pandemic period were associated with mortality during the COVID-19 public health emergency. In this study, we examined the association between social vulnerability, the nurse work environment, and inpatient mortality among Medicare beneficiaries hospitalized with COVID-19. A cross-sectional analysis was conducted of linked survey data collected from nurses working in New York and Illinois, Medicare claims, American Hospital Association Annual Survey data, and the Social Vulnerability Index (SVI). Higher mortality rates were observed among patients in the highest quartile of social vulnerability compared to the lowest (6870 [25.8%] vs 5019 [19.1%]; P < .001). Using multivariable regression modeling, a statistically significant interaction was found between the highest SVI quartile and the nurse work environment (OR, 0.86; 95% CI, 0.76-0.98; P < .05), implying that the effect of a higher quality nurse work environment on mortality was decidedly greater for patients in the highest quartile (odds ratio = 0.86 × 0.94 = 0.80) compared to patients in the lowest quartile (OR, 0.94). Post-hoc analyses demonstrated that hundreds of COVID-19 related deaths among the most socially vulnerable patients may have been avoided if all hospitals had a high-quality nurse work environment. Strengthening the quality of nurse work environments may help to reduce health disparities and should be considered in public health emergency planning, specifically in hospitals serving socially vulnerable communities.

Indexed as

COVID-19MedicareQuality of Health CareAgedCross-Sectional StudiesFemaleHealthcare DisparitiesHospital MortalityHumansMaleNursing Staff, HospitalSARS-CoV-2Social VulnerabilityUnited StatesVulnerable PopulationsWorking ConditionsCOVID-19emergency planningnursingsocial vulnerabilitywork environments

Identifiers

PMID39323090
PMCPMC11430195

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.