Understanding How COVID-19 has Affected Hospital Performance

IMPORTANCE: The novel coronavirus disease (COVID-19) has caused significant challenges for health systems worldwide and has especially challenged the efficiency and effectiveness of many healthcare institutions. Our proposed research will focus on analyzing the impact of COVID-19 on the performance of hospitals across Ontario and generating insights into whether, and to what extent, hospital performance has changed due to COVID-19. METHODS: We will employ descriptive statistics, regression techniques, causal methods, and data envelopment analysis (DEA) to evaluate the relative clinical capabilities of hospitals across Ontario before and after COVID-19. We will use data from the General Medicine Inpatient Initiative (GEMINI) data repository collected from 33 large hospitals across Ontario (covering ~60% of all of Ontario's medical hospital beds). Our proposed research will aim at creating an efficiency classification that identifies high-performing hospitals and determines how each hospital's relative performance ranking has changed due to COVID-19. Subsequent quantitative and qualitative analyses will then identify factors that influence a hospital's performance in combating COVID-19, allowing for interventions to improve preparedness for future health emergencies and pandemics. IMPACT: Our proposed research will advance our understanding of the impact of COVID-19 on hospital performance and allow healthcare institutions to learn from efficient hospitals which have realized relative success in combating COVID-19. Further, this research will generate evidence about all adult medical and intensive care hospitalizations during the pandemic, and thus is directly relevant to numerous marginalized, high risk, and underrepresented populations.