Comparison of the Impact of COVID-19 on Veterans Affairs and Non-federal Hospitals: a Survey of Infection Prevention Specialists

Abstract

Background: As the COVID-19 pandemic evolves, it is critical to understand characteristics that have allowed US healthcare systems, including the Veterans Affairs (VA) and non-federal hospitals, to mount an effective response in the setting of limited resources and unpredictable clinical demands generated by this system shock. Objective: To compare the impact of and response to resource shortages to both VA and non-federal healthcare systems during the COVID-19 pandemic. Design: Cross-sectional national survey administered April 2021 through May 2022. Participants: Lead infection preventionists from VA and non-federal hospitals across the US. Main Measures: Surveys collected hospital demographic factors along with 11 questions aimed at assessing the effectiveness of the hospital’s COVID response. Key Results: The response rate was 56% (71/127) from VA and 47% (415/881) from non-federal hospitals. Compared to VA hospitals, non-federal hospitals had a larger average number of acute care (214 vs. 103 beds, p <0.001). Conclusions: In our survey-based national study, lead infection preventionists noted several distinct advantages in VA versus non-federal hospitals in their ability to expand bed capacity, retain staff, mitigate supply shortages, and avoid financial hardship. While these benefits appear to be inherent to the VA’s structure, non-federal hospitals can adapt their infrastructure to better weather future system shocks.