New Jerseyans are coming to the hospital with more severe levels of illness over the last three years, according to a data analysis released today by the New Jersey Hospital Association.
The proportion of patients with a “major” or “extreme” level of illness now reaches more than 40%, an increase of 21% between 2019 and 2022, as measured by diagnosis codes called the All-Patient Refined Diagnosis Related Group. These codes, commonly called DRGs, assign hospital inpatients a severity level of 1 (mild), 2 (moderate), 3 (major) or 4 (extreme.)
The higher severity levels were observed across inpatients who were in the hospital for a non-COVID illness. The reverse trend was seen among COVID patients; severity levels decreased 44 percent from 2020 to 2022 as hospitals improved their COVID treatments and the virus became less virulent amid wider vaccination and immunity.
This analysis didn’t identify the causes behind the trend toward sicker patients, but an earlier analysis from NJHA and its Center for Health Analytics, Research and Transformation provides some clues. In a paper from December 2021, NJHA identified a significant rise in at-home deaths in 2020, coupled with a decline in hospitalizations for serious health events like heart attacks and strokes. The data suggest that delays in seeking care may have exacerbated health conditions – or caused others to be delayed being diagnosed – during the pandemic.
“There’s no question about it: We’re seeing much sicker patients presenting at our hospitals,” said NJHA President and CEO Cathy Bennett. “That’s a real worry for the health of our population, and an added burden for hospitals and their care teams in the midst of a severe workforce shortage.”
NJHA’s analysis identified two additional trends that raise concerns about the growing severity of illness:
- In 2019, Black and White patients were more likely to be hospitalized with “major” or “extreme” illness compared with other racial and ethnic groups. In 2022 data, every group – including Asians, Hispanics, American Indian/Alaska Native/Native Hawaiian and multiracial – is experiencing similar levels of increased severity of illness.
- The average age of non-COVID patients in hospitals is declining, even as the population ages. For example, among patients with “moderate” levels of illness, the average age was 54 in 2019 and 50 in 2022. That also portends a lower health status.
“New Jersey is moving forward from the pandemic, but it’s important to learn from the experience,” said Bennett. “These are important trendlines to guide strategies to improve the health of our population, and to ensure there are sufficient staff and resources to care for sicker patients.”
The full report is available at www.njha.com/CHART.
