RAND Corporation, Santa Monica, California.
RAND Corporation, Arlington, Virginia.
JAMA Health Forum. 2021 Oct 22;2(10):e213325. doi: 10.1001/jamahealthforum.2021.3325. eCollection 2021 Oct.
In response to financial stress created by the reduction in care during the COVID-19 pandemic, hospitals received financial assistance through the Coronavirus Aid, Relief, and Economic Security (CARES) Act program. To date, the allocation of CARES Act funding is not well understood.
To examine the disbursement of the High-Impact Distribution CARES Act funds and the association between financial assistance and hospital-level financial resources prior to the COVID-19 pandemic.
This cross-sectional analysis of US-based hospitals and health systems assesses the hospital characteristics associated with CARES Act funding with linear regression models using linked hospital and health system-level information on CARES Act funding with hospital characteristics from Hospital Cost Report data.
Hospital and health system CARES Act financial assistance.
Hospital and health system affiliation, status, and financial health prior to the COVID-19 pandemic. Data analysis took place from December 2020 through June 2021.
The analysis included 952 hospital-level entities with an average payment of $33.6 million, most of which was received during the first payment round. Wide ranges existed in CARES Act funding, with 24% of matched hospitals receiving less than $5 million in funding and 8% receiving more than $50 million. Academic-affiliated hospitals, hospitals with higher pre-COVID-19 assets and hospitals with higher COVID-19 cases received higher levels of funding, while critical access hospitals received lower levels of financial assistance. A 10% increase in hospital assets, endowment size, and COVID-19 cases was associated with 1.4% (95% CI, 0.8% to 2.0%; = .003), 0.2% (95% CI, 0.1% to 0.3%; < .001), and 3.5% (95% CI, 2.8% to 4.2%; < .001) increases in CARES Act funding, respectively.
In this cross-sectional study of US hospitals and health systems, findings suggest that High-Impact Distribution CARES Act funds may have disproportionately gone to hospitals that were in a stronger financial situation prior to the pandemic compared with those that were not, but funds also went disproportionately to those that eventually had the most cases.
为应对 COVID-19 大流行期间减少护理带来的财务压力，医院通过《冠状病毒援助、救济和经济安全法案》（CARES 法案）获得了财政援助。迄今为止，CARES 法案资金的分配情况尚不清楚。
研究高影响力分配 CARES 法案资金的使用情况，以及 COVID-19 大流行前医院财务资源与财务援助之间的关系。
设计、地点和参与者：本研究在美国的医院和医疗系统中进行了横断面分析，使用线性回归模型评估了与 CARES 法案资金相关的医院特征，模型使用的是与医院特征相关的链接医院和医疗系统层面的 CARES 法案资金信息，以及医院特征来自医院成本报告数据。
医院和医疗系统的 CARES 法案财政援助。
COVID-19 大流行前医院和医疗系统的隶属关系、地位和财务状况。数据分析于 2020 年 12 月至 2021 年 6 月进行。
分析纳入了 952 个医院级实体，平均支付额为 3360 万美元，其中大部分是在第一轮付款中收到的。CARES 法案资金的范围很广，24%的匹配医院获得的资金不到 500 万美元，8%的医院获得的资金超过 5000 万美元。学术附属医院、COVID-19 病例较多的医院和资产较高的医院获得的资金水平较高，而获得的资金水平较低。医院资产、捐赠规模和 COVID-19 病例每增加 10%，CARES 法案资金就会分别增加 1.4%（95%CI，0.8%至 2.0%；=.003）、0.2%（95%CI，0.1%至 0.3%；<.001）和 3.5%（95%CI，2.8%至 4.2%；<.001）。
在这项对美国医院和医疗系统的横断面研究中，研究结果表明，高影响力分配 CARES 法案资金可能更多地流向了大流行前财务状况较好的医院，而不是财务状况较差的医院，但资金也更多地流向了最终病例最多的医院。
