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Publication Briefs

Veterans with COVID-19 have Greater Risk of Potentially Preventable Hospitalization than Non-infected Veterans


BACKGROUND:
Understanding the influence of COVID-19 infection on potentially preventable hospitalizations is necessary for evaluating whether patients’ post-infection care needs are being met. This study sought to determine whether infection with SARS-CoV-2 is associated with an increased risk of a potentially preventable hospitalization and, if so, how long this association persists after infection. Investigators compared the risk of a potentially preventable hospitalization among Veterans with COVID-19 (n=189,136) and matched uninfected comparators (n=943,084). Data from the VA COVID-19 Shared Data Resource were used to identify COVID-19 diagnoses between March 1, 2020, and April 30, 2021. Investigators also explored the association between COVID-19 and preventable hospitalization during three pandemic waves and among demographic subgroups. The primary outcome was a first potentially preventable hospitalization in VA, VA purchased community care, or Medicare fee-for-service.

FINDINGS:

  • Veterans with COVID-19 had three times greater risk of potentially preventable hospitalization than matched uninfected Veterans within 30 days after infection and more than 40% greater risk at 1 year.
  • Potentially preventable hospitalizations for acute conditions (i.e., bacterial pneumonia, urinary tract infection) accounted for 20% of all preventable hospitalizations; those for exacerbations of chronic conditions (e.g., diabetes complications, asthma) accounted for the remainder.
  • Although exploratory, subgroup results suggest sub-optimal access to ambulatory care either before or after infection increases the risk of a potentially preventable hospitalization in those with COVID-19.

IMPLICATIONS:

  • Findings highlight the need for research on ways in which COVID-19 shapes post-infection care needs and Veterans’ engagement with the health system. Solutions are needed to mitigate preventable hospitalization after COVID-19.

LIMITATIONS:

  • This study did not utilize Medicare Advantage, Medicaid, or commercial insurance data.
  • Untested and/or unreported COVID-19 infections occurred with greater frequency as the pandemic progressed, which could bias study results toward the null.

AUTHOR/FUNDING INFORMATION:
This study was funded by HSR (C19 21-279). Drs. Govier and Niederhausen are with HSR’s Center to Improve Veteran Involvement in Care (CIVIC).


Govier D, Niederhausen M, Takata Y, et al. for the VA HSR COVID-19 Observational Research Collaboratory (CORC). Risk of Potentially Preventable Hospitalizations after SARS-CoV-2 Infection. JAMA Network Open. April 10, 2024;7(4):e245786.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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