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Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study
Regular expert follow‐up, risk assessment, and early therapeutic intervention minimize worsening of pulmonary arterial hypertension (PAH). COVID‐19 lockdown measures were challenging for chronic disease management. This retrospective, longitudinal analysis used US claims data (January 12, 2016 to Se...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493079/ https://www.ncbi.nlm.nih.gov/pubmed/37701141 http://dx.doi.org/10.1002/pul2.12283 |
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author | George, Marjorie Patricia Germack, Hayley D. Goyal, Amit Ward, Charlotte Studer, Sean Panjabi, Sumeet |
author_facet | George, Marjorie Patricia Germack, Hayley D. Goyal, Amit Ward, Charlotte Studer, Sean Panjabi, Sumeet |
author_sort | George, Marjorie Patricia |
collection | PubMed |
description | Regular expert follow‐up, risk assessment, and early therapeutic intervention minimize worsening of pulmonary arterial hypertension (PAH). COVID‐19 lockdown measures were challenging for chronic disease management. This retrospective, longitudinal analysis used US claims data (January 12, 2016 to September 11, 2021) for patients treated with PAH‐specific medication to compare in‐person outpatient and specialist visits, telemedicine visits, and PAH‐related tests during 6‐month assessment periods pre‐ and immediately post‐COVID‐19. Hospitalizations, costs, and outcomes were compared in patients with and without care disruptions (no in‐person or telemedicine outpatient visits in immediate post‐COVID‐19 period). Patients in the immediate post‐COVID‐19 (N = 599) versus the pre‐COVID‐19 period (N = 598) had fewer in‐person outpatient visits (mean 1.27 vs. 2.12) and in‐person specialist visits (pulmonologist, 22.9% vs. 37.0% of patients; cardiologist, 27.5% vs. 33.8%); and more telemedicine visits (mean 0.45 vs. 0.02). In the immediate post‐COVID‐19 period, patients were less likely to have a PAH‐related test versus the pre‐COVID‐19 period (incidence rate ratio: 0.700; 95% confidence interval: 0.615−0.797), including electrocardiograms (41.7% vs. 54.2%) and 6‐minute walk distance tests (16.2% vs. 24.9%). In the immediate post‐COVID‐19 period, 48 patients had care disruptions and, in the following year, required more hospital days than those without care disruptions (N = 240) (median 10 vs. 5 days in total) and had higher overall hospitalization costs (median US$34,755 vs. US$20,090). Our findings support the need for minimizing care disruptions to potentially avoid incremental post‐disruption healthcare utilization and costs among patients with serious chronic diseases such as PAH. |
format | Online Article Text |
id | pubmed-10493079 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104930792023-09-11 Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study George, Marjorie Patricia Germack, Hayley D. Goyal, Amit Ward, Charlotte Studer, Sean Panjabi, Sumeet Pulm Circ Research Articles Regular expert follow‐up, risk assessment, and early therapeutic intervention minimize worsening of pulmonary arterial hypertension (PAH). COVID‐19 lockdown measures were challenging for chronic disease management. This retrospective, longitudinal analysis used US claims data (January 12, 2016 to September 11, 2021) for patients treated with PAH‐specific medication to compare in‐person outpatient and specialist visits, telemedicine visits, and PAH‐related tests during 6‐month assessment periods pre‐ and immediately post‐COVID‐19. Hospitalizations, costs, and outcomes were compared in patients with and without care disruptions (no in‐person or telemedicine outpatient visits in immediate post‐COVID‐19 period). Patients in the immediate post‐COVID‐19 (N = 599) versus the pre‐COVID‐19 period (N = 598) had fewer in‐person outpatient visits (mean 1.27 vs. 2.12) and in‐person specialist visits (pulmonologist, 22.9% vs. 37.0% of patients; cardiologist, 27.5% vs. 33.8%); and more telemedicine visits (mean 0.45 vs. 0.02). In the immediate post‐COVID‐19 period, patients were less likely to have a PAH‐related test versus the pre‐COVID‐19 period (incidence rate ratio: 0.700; 95% confidence interval: 0.615−0.797), including electrocardiograms (41.7% vs. 54.2%) and 6‐minute walk distance tests (16.2% vs. 24.9%). In the immediate post‐COVID‐19 period, 48 patients had care disruptions and, in the following year, required more hospital days than those without care disruptions (N = 240) (median 10 vs. 5 days in total) and had higher overall hospitalization costs (median US$34,755 vs. US$20,090). Our findings support the need for minimizing care disruptions to potentially avoid incremental post‐disruption healthcare utilization and costs among patients with serious chronic diseases such as PAH. John Wiley and Sons Inc. 2023-09-10 /pmc/articles/PMC10493079/ /pubmed/37701141 http://dx.doi.org/10.1002/pul2.12283 Text en © 2023 Janssen. Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Research Articles George, Marjorie Patricia Germack, Hayley D. Goyal, Amit Ward, Charlotte Studer, Sean Panjabi, Sumeet Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study |
title | Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study |
title_full | Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study |
title_fullStr | Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study |
title_full_unstemmed | Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study |
title_short | Impact of the COVID‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the United States of America: An observational study |
title_sort | impact of the covid‐19 pandemic on care disruptions, outcomes, and costs in patients receiving pulmonary arterial hypertension‐specific therapy in the united states of america: an observational study |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493079/ https://www.ncbi.nlm.nih.gov/pubmed/37701141 http://dx.doi.org/10.1002/pul2.12283 |
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