Long-COVID and Use of Healthcare Resources: A Retrospective Population-Based Matched Cohort Study Comparing Individuals with and Without Previous SARS-CoV-2 Infection Over 6 Months

Castriotta, Luigi; Onder, Graziano; Rosolen, Valentina; Beorchia, Yvonne; Fanizza, Caterina; Bellini, Benedetta; Floridia, Marco; Giuliano, Marina; Silenzi, Andrea; Pricci, Flavia; Grisetti, Tiziana; Grassi, Tiziana; Tiple, Dorina; Villa, Marika; Pennacchio, Francesco; Francesconi, Paolo; Barbone, Fabio; Bisceglia, Lucia; Brusaferro, Silvio

doi:10.2139/ssrn.4496142

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most studies that have assessed the individual-level effect of COVID-19 infection on health care use were based on pre-post designs following a positive COVID-19 test 9 or compared patients with post–COVID-19 condition (PCC) with COVID-19–positive patients without long-term complications of COVID-19. 10 , 11 To our knowledge, only 2 prior studies 12 , 13 compared differences in health care use between infected and matched uninfected cohorts. Both studies found that COVID-19–infected patients had more health care encounters and outpatient visits than did patients without infection over 6 months 12 or 12 months.…”

Section: Introductionmentioning

confidence: 99%

Changes in Outpatient Health Care Use After COVID-19 Infection Among Veterans

Hebert,

Kumbier,

Smith

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceThe association of COVID-19 infection with outpatient care utilization is unclear. Many studies reported population surveillance studies rather than comparing outpatient health care use between COVID-19–infected and uninfected cohorts.ObjectiveTo compare outpatient health care use across 6 categories of care (primary care, specialty care, surgery care, mental health, emergency care, and diagnostic and/or other care) between veterans with or without COVID-19 infection.Design, Setting, and ParticipantsIn a retrospective cohort study of Veterans Affairs primary care patients, veterans with COVID-19 infection were matched to a cohort of uninfected veterans. Data were obtained from the Veterans Affairs Corporate Data Warehouse and the Centers for Medicare &amp; Medicaid Services Fee-for-Service Carrier/Physician Supplier file from January 2019 through December 2022. Data analysis was performed from September 2022 to April 2023.ExposureCOVID-19 infection.Main Outcomes and MeasuresThe primary outcome was the count of outpatient visits after COVID-19 infection. Negative binomial regression models compared outpatient use over a 1-year preinfection period, and peri-infection (0-30 days), intermediate (31-183 days), and long-term (184-365 days) postinfection periods.ResultsThe infected (202 803 veterans; mean [SD] age, 60.5 [16.2] years; 178 624 men [88.1%]) and uninfected (202 803 veterans; mean [SD] age, 60.4 [16.5] years; 178 624 men [88.1%]) cohorts were well matched across all covariates. Outpatient use in all categories (except surgical care) was significantly elevated during the peri-infection period for veterans with COVID-19 infection compared with the uninfected cohort, with an increase in all visits of 5.12 visits per 30 days (95% CI, 5.09-5.16 visits per 30 days), predominantly owing to primary care visits (increase of 1.86 visits per 30 days; 95% CI, 1.85-1.87 visits per 30 days). Differences in outpatient use attenuated over time but remained statistically significantly higher at 184 to 365 days after infection (increase of 0.25 visit per 30 days; 95% CI, 0.23-0.27 visit per 30 days). One-half of the increased outpatient visits were delivered via telehealth. The utilization increase was greatest for veterans aged 85 years and older (6.1 visits, 95% CI, 5.9-6.3 visits) vs those aged 20 to 44 years (4.8 visits, 95% CI, 4.7-4.8 visits) and unvaccinated veterans (4.5 visits, 95% CI, 4.3-4.6 visits) vs vaccinated veterans (3.2 visits; 95% CI, 3.4-4.8 visits).Conclusions and RelevanceThis study found that outpatient use increased significantly in the month after infection, then attenuated but remained greater than the uninfected cohorts’ use through 12 months, which suggests that there are sustained impacts of COVID-19 infection.

show abstract