# The Impact of the Burden of COVID-19 Regulatory Reporting in a Small Independent Hospital and a Large Network Hospital: Comparative Mixed Methods Study

## TL;DR

This study compares how regulatory reporting during the pandemic affected a small hospital and a large hospital, showing that smaller hospitals faced bigger challenges due to limited resources.

## Contribution

The study highlights institutional inequities in health IT capabilities and their impact on pandemic response.

## Key findings

- Small hospitals faced significant time burdens from reporting, reducing patient care time.
- Large hospitals used dedicated staff and better systems to manage reporting more efficiently.
- Health IT disparities may hinder smaller hospitals' pandemic response and public health support.

## Abstract

During the COVID-19 pandemic in 2020, hospitals encountered numerous challenges that compounded their difficulties. Some of these challenges directly impacted patient care, such as the need to expand capacities, adjust services, and use new knowledge to save lives in an ever-evolving situation. In addition, hospitals faced regulatory challenges.

This paper presents the findings of a qualitative study that aimed to compare the effects of reporting requirements on a small independent hospital and a large network hospital during the COVID-19 pandemic.

We used both quantitative and qualitative analyses and conducted 51 interviews, which were thematically analyzed. We quantified the changes in regulatory reporting requirements during the first 14 months of the pandemic.

Reporting requirements placed a substantial time burden on key clinical personnel at the small independent hospital, consequently reducing the time available for patient care. Conversely, the large network hospital had dedicated nonclinical staff responsible for reporting duties, and their robust health information system facilitated this work.

The discrepancy in health IT capabilities suggests that there may be significant institutional inequities affecting smaller hospitals’ ability to respond to a pandemic and adequately support public health efforts. Electronic certification guidelines are essential to addressing the substantial equity issues. We discuss in detail the health care policy implications of these findings.