Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

COVID-19 Post-hospitalization Health Care Utilization: A Living Review

Click for list of published reports
Click for topic nomination form
Click for list of reports in progress

Subscribe to the
ESP Report RSS feed RSS feed icon
COVID-19 Post-hospitalization Health Care Utilization: A Living Review

Prepared by:
Evidence Synthesis Program (ESP)
Durham VA Health Care System
Durham, NC
Jennifer M. Gierisch, PhD, MPH, Co-Director
Karen M. Goldstein, MD, MSPH, Co-Director

Recommended citation:
Sharpe JA, Burke C, Gordon AM, Gierisch JM, Allen KD, Goode AP, Ballengee L, Shepherd-Banigan M, Hughes JM, Hastings SN, Van Houtven C, Goldstein KM, Zullig LL, Kosinski AS, Dickerson SW, Cantrell S, Ear B, Williams JW Jr. COVID-19 Post-hospitalization Health Care Utilization: A Living Review. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-010; 2022.



Download PDF: Complete Report, Report, Appendices

Takeaway

After updating the search, the review includes 19 cohort studies. We continue to conclude that a substantial proportion of adults with COVID-19 post-hospitalization required continued care in a skilled nursing or rehabilitation facility or utilized home health services post-discharge. However, short-term readmission rates were modest. These data suggest that health care systems will need post-acute care services including home health, and rehabilitation capacity to support patients' needs following discharge.

Context

SARS-CoV-2 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. At its peak, more than 26 of every 100,000 adult Americans were hospitalized for COVID-19. The objective for this review was to determine short-and long-term health care utilization following a COVID-19–related hospitalization.

Key Findings

We identified 6 eligible cohort studies (4982 participants) conducted in Europe or the United States early in the pandemic. ROB was assessed as low in the largest study, unclear in 4 studies, and high in 1 study. Most surviving patients were discharged home, but a substantial proportion were discharged to a skilled nursing facility or rehabilitation facility (median 13%; range 6.7% to 29.2%; n=4 studies, 930 patients). After discharge, 4.5% (range 1.9% to 11.1%; n=5 studies, 4552 patients) were readmitted to the hospital at a median of 37 days follow up. One high ROB study, restricted to higher severity patients (n=161), reported high rates of home health services and home oxygen requirement. Other outcomes including emergency department visits, palliative care use, home health, and durable medical equipment-mobility aids were reported infrequently. Study heterogeneity precluded meta-analysis, and the certainty of evidence for all outcomes was very low.

See also

COVID-19 Post-hospitalization Healthcare Utilization: A Living Review (Management eBrief)


Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.