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Healthcare Utilization Among Patients Diagnosed with COVID-19 in a Large Integrated Health System.
Huang, Brian Z; Creekmur, Beth; Yoo, Michael S; Broder, Benjamin; Subject, Christopher; Sharp, Adam L.
  • Huang BZ; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
  • Creekmur B; Department of Population and Public Health Sciences, Keck School of Medicine of USC, CA, Los Angeles, USA.
  • Yoo MS; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
  • Broder B; The Permanente Medical Group, Kaiser Permanente Santa Rosa Medical Center, Santa Rosa, CA, USA.
  • Subject C; Southern California Permanente Medical Group, Baldwin Park Medical Center, Baldwin Park, CA, USA.
  • Sharp AL; Southern California Permanente Medical Group, Los Angeles Medical Center, Los Angeles, CA, USA.
J Gen Intern Med ; 37(4): 830-837, 2022 03.
Article in English | MEDLINE | ID: covidwho-1611481
ABSTRACT

BACKGROUND:

The demands for healthcare resources following a COVID-19 diagnosis are substantial, but not currently quantified.

OBJECTIVE:

To describe trends in healthcare utilization within 180 days for patients diagnosed with COVID-19 and identify patient factors associated with increased healthcare use.

DESIGN:

Observational cohort study. PATIENTS A total of 64,011 patients with a test-confirmed COVID-19 diagnosis from March to September 2020 in a large integrated healthcare system in Southern California. MAIN

MEASURES:

Overall healthcare utilization during the 180 days following COVID-19 diagnosis, as well as encounter types and reasons for visits during the first 30 days. Poisson regression was used to identify patient factors associated with higher utilization. Analyses were performed separately for patients who were and were not hospitalized for COVID-19. KEY

RESULTS:

Healthcare utilization was about twice as high for hospitalized patients compared to non-hospitalized patients in all time periods. The average number of visits was highest in the first 30 days (hospitalized 12.3 visits/30 person-days; non-hospitalized 6.6) and gradually decreased over time. In the first 30 days, the majority of healthcare visits were telehealth encounters (hospitalized 9.0 visits; non-hospitalized 5.6 visits), and the most prevalent reasons for visits were COVID-related diagnoses, COVID-related symptoms, and respiratory-related conditions. For hospitalized patients, older age (≥65 RR 1.27, 95% CI 1.15-1.41), female gender (RR 1.07, 95% CI 1.05-1.09), and higher BMI (≥40 RR 1.07, 95% CI 1.03-1.10) were associated with higher total utilization. For non-hospitalized patients, older age, female gender, higher BMI, non-white race/ethnicity, former smoking, and greater number of pre-existing comorbidities were all associated with increased utilization.

CONCLUSIONS:

Patients with COVID-19 seek healthcare frequently within 30 days of diagnosis, placing high demands on health systems. Identifying ways to support patients diagnosed with COVID-19 while adequately providing the usual recommended care to our communities will be important as we recover from the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Acceptance of Health Care / Delivery of Health Care, Integrated / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-021-07139-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Acceptance of Health Care / Delivery of Health Care, Integrated / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-021-07139-z