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COVID-19 后 COPD 患者的医疗保健利用
Authors Puebla Neira D , Zaidan M, Nishi S, Duarte A, Lau C, Parthasarathy S, Wang J, Kuo YF, Sharma G
Received 9 May 2023
Accepted for publication 6 August 2023
Published 22 August 2023 Volume 2023:18 Pages 1827—1835
DOI https://doi.org/10.2147/COPD.S415621
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Rationale: There is concern that patients with chronic obstructive pulmonary disease (COPD) are at greater risk of increased healthcare utilization (HCU) following Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-COV-2) infection.
Objective: To assess whether COPD is an independent risk factor for increased post-discharge HCU.
Methods: We conducted a retrospective cohort study of patients with COPD discharged home from a hospitalization due to Coronavirus Disease 2019 (COVID-19) between April 1, 2020, and March 31, 2021, using Optum’s de-identified Clinformatics® Data Mart Database (CDM). COVID-19 was identified by an International Classification of Diseases, tenth revision, clinical modification (ICD-10-CM) diagnosis code of U07.1. The primary outcome was HCU (ie, emergency department (ED) visits, readmissions, rehabilitation/skilled nursing facility (SNF) visits, outpatient office visits, and telemedicine visits) nine months post-discharge after COVID-19 hospitalization (from here on “post-discharge”) in patients with COPD compared to HCU of patients without COPD. Poisson regression modeling was used to calculate relative risk (RR) and confidence interval (CI) for COPD, adjusted for the other covariates.
Results: We identified a cohort of 160,913 patients hospitalized with COVID-19, with 57,756 discharged home and 14,622 (25.3%) diagnosed with COPD. Patients with COPD had a mean age of 75.48 years (± 9.49); 55.5% were female and 70.9% were White. Patients with COPD had an increased risk of HCU in the nine months post-discharge after adjusting for the other covariates. Risk of ED visits, readmissions, length of stay during readmission, rehabilitation/SNF visits, outpatient office visits, and telemedicine visits were increased by 57% (RR 1.57; 95% CI 1.53– 1.60), 50% (RR 1.50; 95% CI 1.46– 1.54), 55% (RR 1.55; 95% CI 1.53– 1.56), 18% (RR 1.18; 95% CI 1.14– 1.22), 16% (RR 1.16; 95% CI 1.16– 1.17), and 28% (RR 1.28; 95% CI 1.24– 1.31), respectively. Younger patients (ages 18 to 65 years), women, and Hispanic patients with COPD showed an increased risk for post-discharge HCU.
Conclusion: Patients with COPD hospitalized with COVID-19 experienced increased HCU post-discharge compared to patients without COPD.
Keywords: COPD, Healthcare Utilization disease, COVID-19
