Higher health care utilization seen up to 9 months after hospitalization for COVID-19

NASHVILLE, Tenn. — Study results presented at the CHEST Annual Meeting demonstrated higher health care utilization up to 9 months after hospitalization for COVID-19 compared with before hospitalization.

“We hypothesized that the health care utilization of those discharged after a COVID infection and hospitalization would remain high and actually certain specialties will be utilized disproportionately compared to the others,” Mohammed F. Zaidan, MD, assistant professor in the department of internal medicine in the division of pulmonary, critical care and sleep medicine at The University of Texas Medical Branch in Galveston, Texas, said during the presentation.

Researchers analyzed deidentified data from Optum’s Clinformatics Data Mart of 63,161 adults (mean age, 72.4 years; 53.7% women; 58.8% white) who were hospitalized with a primary COVID-19 diagnosis and discharged home between April 2020 to March 2021. Researchers compared health care utilization — defined as ED visits, hospital readmission, outpatient clinic visits and telemedicine visits — of this patient group prior to and 9 months following hospitalization. They also evaluated the distribution of specialties including primary care, psychiatry, pulmonology, cardiology, endocrinology, mental health, physiatrists and neurology seen in the outpatient and office settings.

Regarding comorbidities in this patient group, most had hypertension (75.8%), followed by diabetes (36.5%), congestive heart failure (25.8%), coronary artery disease (25.2%) and COPD (23%).

Overall, results showed health care utilization for outpatient visits increased by 65% (156.5 vs. 257.5 per 10,000 person-days), inpatient readmissions more than doubled (7 vs. 15.4 per 10,000 person-days) and ED visits increased by about 47% (22 vs. 32.3 per 10,000 person days) from before to following hospitalization.

Most health care utilization was provided during the first 3 months of being discharged home and tapered off over time. Researchers observed an increase in primary care visits of about 69% (78.8 vs. 133.1 per 10,000 person-days), pulmonary clinic visits by more than 235% (3.8 vs. 12.9 per 10,000 person-days) and cardiology clinic visits by 80% (12.2 vs. 21.9 per 10,000 person-days). Neurologists, psychiatrists and other mental health professionals also experienced increases in clinic visits of about 46%.

Surprisingly, Zaidan noted, 27.1% of patients who were discharged home after COVID-19 hospitalization were prescribed supplemental oxygen. However, this proportion decreased at each 3-month interval following hospitalization to 15.2% at 1 to 3 months, 7.6% at 3 to 6 months, 2.9% at 6 to 9 months and then 1.3% after 9 months.

“We hope the health care systems and providers can utilize this information to better deploy resources in the care of this population and that future studies can be focused on this as well,” Zaidan said.

Reference:

Zaidan MF, et al. Chest. 2022;doi:10.1016/j.chest.2022.08.401.