‘Dramatic spike’ in eating disorder hospitalizations occurred during COVID-19 pandemic
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Inpatient stays for eating disorders increased during the COVID-19 pandemic, according to results of a cohort study in a research letter published in JAMA Network Open.
“Even at the pandemic’s start, many people within the health care field recognized it would fundamentally change how health care was delivered not just for patients with COVID-19, but for all patients,” David A. Asch, MD, MBA, executive director of the Center for Health Care Innovation at the University of Pennsylvania, told Healio Psychiatry. “At the same time, people outside of the health care field could see how drastically their own lives changed, and their practices around eating were a big part of that change.”
Asch and colleagues investigated trends in health care for eating disorders between January 2018 and December 2020, as well as other common behavioral health conditions, among a large cohort of individuals with commercial insurance in the U.S. They counted the unique individuals per 100,000 members per month who had outpatient or inpatient care and a primary diagnosis according to ICD-10 criteria for eating disorders, alcohol use disorders, depression, anxiety, suicidality or opioid use disorders. They excluded outpatient claims from members with inpatient claims in the same condition-month and ED claims.
Asch and colleagues included 3,281,366 individuals (62.6% women; mean age, 37.7 years). They noted similar patient characteristics across years, aside from the age of patients with eating disorders decreasing over time. Results showed the number of patients with inpatient care for eating disorders stayed around approximately 0.3 per 100,000 members per month until May 2020, at which point it reached 0.6. The researchers observed this increase across anorexia nervosa, bulimia nervosa and other and unspecified eating disorders. Further, they reported an increase in the median length of inpatient stays from 9 days and 8 days in June to December of 2018 and 2019, respectively, to 12 days in the same time frame in 2020. The number of patients with outpatient care for eating disorders rose from around 25 patients per 100,000 per month to 29 patients per 100,000 per month. Asch and colleagues did not observe similar increases for the three comparison behavioral health conditions.
“A dramatic spike in hospitalizations for eating disorders means we somehow failed to recognize or address the problem before it got that bad,” Asch said. “Maybe there was something we could have done sooner or better.”