Leahy Jasmine, Bajracharya Rebecca, Altonen Brian, Ferreira-Ortiz Maria, Silvera Leopolda, Astua Alfred J
Pulmonary Critical Care, Icahn School of Medicine at Mount Sinai, New York, USA.
Biostatistics and Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA.
Cureus. 2023 Dec 17;15(12):e50663. doi: 10.7759/cureus.50663. eCollection 2023 Dec.
Despite the rise of post-COVID care centers, few studies exist that quantify the burden of patient healthcare usage and hospital costs after COVID-19 hospitalization. It is essential to target post-COVID follow-up care to the individuals who need it most, such that costs and emergencies are minimized and health and appointment attendance are optimized.
This was a retrospective cohort comparison among four groups of 50 patients (200 total). Post-discharge healthcare utilization metrics were collected for individuals hospitalized with COVID-19 during the first four surges of the pandemic to compare how patients receive and seek care in the year after they contract COVID-19. A brief cost analysis was done to identify high-usage groups that could be targeted for intervention to decrease post-COVID hospitalization emergencies and burden.
Patients hospitalized during the Omicron surge were scheduled for the most specialist visits on average, significantly higher than average specialist visits in the Delta surge (p<0.05). The Delta surge had significantly less specialty care and missed visits than all other surges (p<0.05) and less primary care than the first two surges of the pandemic (p<0.05). Patients with type 2 diabetes and asthma had the highest overall costs (p<0.05). Females and Hispanic patients had the highest specialty and ED costs (p<0.05).
Each surge reflects a different approach to post-COVID care, with the Omicron surge demonstrating the heaviest usage overall, particularly with specialty visits. Increased specialty referrals may exacerbate rates of missed appointments, while primary care may lower emergency visits. Future approaches to post-COVID care design should identify patients at risk for emergencies and reinstate them with primary care.
尽管新冠后护理中心有所增加,但很少有研究对新冠住院后患者的医疗使用负担和医院成本进行量化。至关重要的是,针对最需要的个体提供新冠后随访护理,从而将成本和紧急情况降至最低,并优化健康状况和预约就诊率。
这是一项对四组每组50名患者(共200名)的回顾性队列比较研究。收集了在疫情前四次高峰期间因新冠住院患者出院后的医疗利用指标,以比较患者在感染新冠后一年中接受和寻求护理的方式。进行了简要的成本分析,以确定可作为干预目标的高使用量群体,以减少新冠后住院紧急情况和负担。
在奥密克戎高峰期间住院的患者平均安排的专科就诊次数最多,显著高于德尔塔高峰期间的平均专科就诊次数(p<0.05)。德尔塔高峰期间的专科护理和漏诊次数明显少于所有其他高峰(p<0.05),初级护理次数少于疫情前两次高峰(p<0.05)。2型糖尿病和哮喘患者的总体成本最高(p<0.05)。女性和西班牙裔患者的专科和急诊成本最高(p<0.05)。
每次高峰都反映了新冠后护理的不同方式,奥密克戎高峰期间总体使用量最大,尤其是专科就诊。专科转诊增加可能会加剧漏诊率,而初级护理可能会降低急诊就诊率。未来新冠后护理设计的方法应识别有紧急情况风险的患者,并让他们恢复接受初级护理。