ABSTRACT
BACKGROUND: The impact of migr2D) and cardiovascular disease (CVD) are associated with increased morbidity and mortality in COVID-19 (C-19) patients. However, the economic burden associated with these pre-existing comorbidities is not well understood. OBJECTIVE(S): This study aimed to compare the healthcare resource utilization (HCRU) and costs among C-19 patients with pre-existing T2D + CVD, T2D only, or neither. METHOD(S): This retrospective study used administrative claims in the HealthCore Integrated Research Database from US commercial and Medicare Advantage health plans. Patients with C-19 were identified from March 1, 2020-May 31, 2021, and stratified by presence of T2D and CVD. HCRU and costs were identified during follow-up and presented on a per patient per month (PPPM) basis. Propensity score matching and multivariable analyses were performed to adjust for differences between the three groups. RESULT(S): A total of 321,232 C-19 patients were identified (21,651 T2D + CVD, 28,184 T2D only, and 271,397 neither) with a mean follow-up of 5.4 months. C-19 patients with T2D + CVD were significantly older and had a greater comorbidity burden than those with neither. The unadjusted analysis shows that PPPM costs during follow-up were $14,790, $5,717, and $1,891 for T2D + CVD, T2D only, and neither, respectively, with C-19 related costs contributing 78%, 75%, and 64% of the overall costs. The majority of costs occurred during the first month after C-19 infection. After matching, 6,967 patients were identified for each cohort. Hospitalization occurred in 34.2% (T2D + CVD), 26.0% (T2D only), and 21.2% (neither), with a mean length of stay of 9.5, 9.9, and 8.9 days. Emergency room visits were reported in 28.6%, 24.5% and 20.4%, respectively. In-person physician and telehealth visits followed a similar pattern, with the highest number of visits among C-19 patients with T2D + CVD. Multivariable models show that C-19 patients with T2D + CVD were 59% more likely to be hospitalized, incurring 54% greater costs than those with neither. Patients with T2D only were 28% more likely to be hospitalized with 21% greater costs than those with neither. CONCLUSION(S): C-19 patients with pre-existing T2D + CVD had the greatest economic burden even after accounting for baseline differences between groups. The magnitude of increased HCRU and costs suggests that more aggressive triage and management of C-19 patients with both T2D and CVD may favorably impact economic outcomes.
ABSTRACT
Background: The importance of a dedicated, embedded communications team within the UAB Department of Pathology has never been more evident than during the past 18 months, when the world experienced a global pandemic. As the university and hospital system's messaging focus necessitated a pivot to covering COVID19, having a team of highly trained individuals within the department allowed for timely, thoughtful messaging to our constituents, both internal and external. Design: Our team expanded from a single full-time employee to add an intern, who became a second full-time employee, as our scope of work continues to broaden. In addition to the usual communications at the school- and institution levels, the department saw a need for and value in having this team to disseminate information across a variety of platforms, in real time. This team has direct, regular interactions with the department chair and executive leadership to determine key messaging'a crucial element to successfully communicating what is necessary (and not fatiguing our audiences) during the pandemic, as rules and guidelines change constantly. We manage and create original news content for our department's website, a YouTube channel, a monthly newsletter, and an annual magazine, in addition to digital signage (located in high-traffic areas of our hospital). In the past 18 months we expanded from social media accounts on two platforms (Twitter, Facebook) to add Instagram and LinkedIn profiles;all four have greatly expanded impressions, engagements and followers in the past 18 months (or since account inception). Our communications director serves on both the wellness and the diversity, equity and inclusion committees for our department, further enhancing the breadth of offerings we provide to the department at large. Results: Stories about our department faculty and their leadership during the pandemic, generated in part by our team, garnered increased visibility for our program nationwide. In addition to timely communication in a crisis situation, our team supports the necessary pivot by programs such as Grand Rounds, endowed lectureships and other in-person talks and meetings with digitally recorded webinars. This includes a 100% virtual residency and fellowship recruitment program, for the first time in our 30-year training program history. We also offered a series of lectures on best practices for communications in science. Conclusions: Communication is a crucial element of effective leadership of your pathology department.
ABSTRACT
Wellbeing can be affected by many different factors, and it influences productivity at work. Following the Covid-19 pandemic, the importance of understanding how to manage your personal and team wellbeing is even greater. This article highlights some key questions to ask yourself about your working life, and suggests some top wellbeing tips.