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
Abstract 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, 2...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | Pulmonary Circulation |
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| Online Access: | https://doi.org/10.1002/pul2.12283 |
| _version_ | 1797672351146442752 |
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| author | Marjorie Patricia George Hayley D. Germack Amit Goyal Charlotte Ward Sean Studer Sumeet Panjabi |
| author_facet | Marjorie Patricia George Hayley D. Germack Amit Goyal Charlotte Ward Sean Studer Sumeet Panjabi |
| author_sort | Marjorie Patricia George |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-11T21:28:42Z |
| format | Article |
| id | doaj.art-560083797319426c82be2411530670f8 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-03-11T21:28:42Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-560083797319426c82be2411530670f82023-09-27T13:33:25ZengWileyPulmonary Circulation2045-89402023-07-01133n/an/a10.1002/pul2.12283Impact 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 studyMarjorie Patricia George0Hayley D. Germack1Amit Goyal2Charlotte Ward3Sean Studer4Sumeet Panjabi5Division of Pulmonary, Critical Care & Sleep Medicine National Jewish Health Denver Colorado USAJanssen Scientific Affairs Titusville New Jersey USAZS Associates Evanston Illinois USAZS Associates Evanston Illinois USAMedical Affairs Janssen Pharmaceuticals US, Inc. Titusville New Jersey USAJanssen Scientific Affairs Titusville New Jersey USAAbstract 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.https://doi.org/10.1002/pul2.12283care accessCOVID‐19pulmonary hypertension |
| spellingShingle | Marjorie Patricia George Hayley D. Germack Amit Goyal Charlotte Ward Sean Studer Sumeet Panjabi 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 Pulmonary Circulation care access COVID‐19 pulmonary hypertension |
| 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 | care access COVID‐19 pulmonary hypertension |
| url | https://doi.org/10.1002/pul2.12283 |
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