Hospital COVID-19 preparedness: Are (were) we ready?




emergency department, change, beds, hospital, American Hospital Association, COVID-19


Background: Terrorist attacks and natural disasters such as Hurricanes Katrina and Harvey have increased focus on disaster preparedness planning. Despite the attention on planning, many studies have found that hospitals in the United States are underprepared to manage extended disasters appropriately and the surge in patient volume it might bring.

Aim: This study aims to profile and examine the availability of hospital capacity specifically related to COVID-19 patients, such as emergency department (ED) beds, intensive care unit (ICU) beds, temporary space setup, and ventilators.

Method: A cross-sectional retrospective study design was used to examine secondary data from the 2020 American Hospital Association (AHA) Annual Survey. A series of multivariate logistic analyses were conducted to investigate the strength of association between changes in ED beds, ICU beds, staffed beds, and temporary spaces setup, and the 3,655 hospitals’ characteristics.

Results: Our results highlight that the odds of a change in ED beds are 44 percent lower for government hospitals and 54 percent for for-profit hospitals than not-for-profit hospitals. The odds of ED bed change for nonteaching hospitals were 34 percent lower compared to teaching hospitals. Small and medium hospitals have significantly lower odds (75 and 51 percent, respectively) than large hospitals. For ICU bed change, staffed bed change, and temporary spaces setup, the conclusions were consistently significant regarding the impact of hospital ownership, teaching status, and hospital size. However, temporary spaces setup differs by hospital location. The odds of change is significantly lower (OR = 0.71) in urban hospitals compared with rural hospitals, while for ED beds, the odds of change is considerably higher (OR = 1.57) in urban hospitals compared to rural hospitals.

Conclusion: There is a need for policymakers to consider not only resource limitations that were created from supply line disruptions during the COVID-19 pandemic but also a more global assessment of the adequacy of funding and support for insurance coverage, hospital finance, and how hospitals meet the needs of the populations they serve.

Author Biographies

Mei Zhao, PhD

Professor and Chair, Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida

Hanadi Y. Hamadi, PhD

Associate Professor, Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida

D. Rob Haley, PhD, MBA, MHS

Professor, Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida

Jing Xu, PhD, MHA

Assistant Professor, Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida

Ajani (AJ) Dunn, MHA, FACHE

Assistant Professor and Chief Administrative Officer, Health Care Systems Engineering, Mayo Clinic College of Medicine and Science, Mayo Clinic, Jacksonville, Florida

Aaron Spaulding, PhD

Associate Professor, Department of Health Sciences Research, Division of Health Care Policy and Research, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida


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How to Cite

Zhao, M., H. Y. Hamadi, D. R. Haley, J. Xu, A. (AJ) Dunn, and A. Spaulding. “Hospital COVID-19 Preparedness: Are (were) We Ready?”. American Journal of Disaster Medicine, vol. 17, no. 4, July 2023, pp. 341-52, doi:10.5055/ajdm.2022.0449.