Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jan 16, 2024
Date Accepted: Jul 21, 2024
Healthcare resource utilization and total mortality after hospital admission for severe COVID-19 infections during the initial pandemic wave in France – descriptive study
ABSTRACT
Background:
Little is known about post-hospital healthcare resource use (HRU) of patients admitted for severe COVID-19, specifically for the care of Post-Acute COVID-19 Syndrome (PACS).
Objective:
A list of HRU domains and items potentially related to PACS was defined, and Potential PACS-Related HRU (PPRH) was compared between the pre- and post-COVID periods, to identify new outpatient care likely related to PACS.
Methods:
A retrospective cohort study was conducted with the French National Health System claims data (SNDS). All patients hospitalized for COVID-19 between 2020/02/01 and 2020/06/30 were described and investigated for 6 months, using discharge date as index date. Patients who died during index stay or within 30 days after discharge were excluded. PPRH was assessed over the 5 months from day 31 after index date to end of follow-up, i.e. for the post-COVID period. For each patient, a pre-COVID period was defined that covered the same calendar time in 2019, and pre-COVID PPRH was assessed. Post/pre ratios (PP Ratios) of % users were computed with their 95CIs and PPRs >1.2 were considered as ‘major HRU change’.
Results:
The final study population included 68,822 patients (median age: 64.8 years, 47% women, median follow-up duration: 179.3 days). Altogether, 22.8% of the patients admitted for severe COVID died during the hospital stay or within the 6 months following discharge. Eight HRU domains were selected to study PPRH: medical visits, technical procedures, dispensed medications, biological analyses, oxygen therapy, rehabilitation, re-hospitalizations, and nurse visits. PPRs showed novel outpatient care in all domains and in most items, without specificity, with the highest ratios observed for the care of thoracic conditions.
Conclusions:
Patients hospitalized for severe COVID during the initial pandemic wave had high morbi-mortality. The analysis of HRU domains and items most likely to be related to PACS showed that new care was commonly initiated after discharge but with no specificity, suggesting that any impact of PACS was part of the overall high HRU of this population after hospital discharge. Clinical Trial: NCT05073328
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