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Cirrhosis hospitalizations are declining during the coronavirus pandemic, according to researchers from the University of Pennsylvania and Corporal Michael J. Crescenz US Department of Veterans Affairs Medical Center in Philadelphia. They found a “clear drop-off” among patients who ordinarily would meet acute care criteria.
Using data from the Veterans Outcomes and Costs Associated with Liver Disease (VOCAL) cohort, the researchers collected data that included length of stay, type of hospital, and region for 7,216 patients and 12,467 hospitalizations between January 1 and April 15 in 2019 and 2020. They designated 3 2020 subgroups: pre-COVID (before February 29), early COVID (February 29 - March 25), and late COVID (March 26 - April 15). The breakpoints were chosen because the Veterans Health Administration announced a COVID-19 Response Plan on March 23 that was implemented widely within 3 days.
Analyzing the differences in data from the 2 years, the researchers found weekly cirrhosis hospitalizations were on average 159.5 fewer in the late-COVID era, while admissions for end-stage liver disease were significantly higher. Patients also had shorter lengths of stay in 2020 when compared with 2019 (median, 2 days vs 3), and fewer hospital transfers (7.5% vs 11.1%).
The late-COVID era also was characterized by significantly fewer academic hospital admissions (63.6% vs 68.1% pre-COVID). And more patients were discharged to home in the late-COVID era (91.1% vs 88.8% pre-COVID) and fewer to facilities (5.1% vs 9.0% pre-COVID).
The changes likely reflect initiatives to preserve inpatient resources, the researchers say. “Importantly,” they suggest, their findings probably “parallel changes in other inpatient resource-intensive conditions,” such as congestive heart failure, chronic obstructive pulmonary disease, and myocardial infarction.
The pandemic response also may be sending conflicting messages to people who already have serious illnesses: Patients may be following guidance encouraging them to stay home, or avoiding going to the hospital until their symptoms are severe, perhaps from fears about COVID-19.
It is unclear how these patients are being managed, the researchers add. “Given the baseline vulnerability of patients with cirrhosis, it is likely that many do not currently have adequate healthcare access.”
Cirrhosis hospitalizations are declining during the coronavirus pandemic, according to researchers from the University of Pennsylvania and Corporal Michael J. Crescenz US Department of Veterans Affairs Medical Center in Philadelphia. They found a “clear drop-off” among patients who ordinarily would meet acute care criteria.
Using data from the Veterans Outcomes and Costs Associated with Liver Disease (VOCAL) cohort, the researchers collected data that included length of stay, type of hospital, and region for 7,216 patients and 12,467 hospitalizations between January 1 and April 15 in 2019 and 2020. They designated 3 2020 subgroups: pre-COVID (before February 29), early COVID (February 29 - March 25), and late COVID (March 26 - April 15). The breakpoints were chosen because the Veterans Health Administration announced a COVID-19 Response Plan on March 23 that was implemented widely within 3 days.
Analyzing the differences in data from the 2 years, the researchers found weekly cirrhosis hospitalizations were on average 159.5 fewer in the late-COVID era, while admissions for end-stage liver disease were significantly higher. Patients also had shorter lengths of stay in 2020 when compared with 2019 (median, 2 days vs 3), and fewer hospital transfers (7.5% vs 11.1%).
The late-COVID era also was characterized by significantly fewer academic hospital admissions (63.6% vs 68.1% pre-COVID). And more patients were discharged to home in the late-COVID era (91.1% vs 88.8% pre-COVID) and fewer to facilities (5.1% vs 9.0% pre-COVID).
The changes likely reflect initiatives to preserve inpatient resources, the researchers say. “Importantly,” they suggest, their findings probably “parallel changes in other inpatient resource-intensive conditions,” such as congestive heart failure, chronic obstructive pulmonary disease, and myocardial infarction.
The pandemic response also may be sending conflicting messages to people who already have serious illnesses: Patients may be following guidance encouraging them to stay home, or avoiding going to the hospital until their symptoms are severe, perhaps from fears about COVID-19.
It is unclear how these patients are being managed, the researchers add. “Given the baseline vulnerability of patients with cirrhosis, it is likely that many do not currently have adequate healthcare access.”
Cirrhosis hospitalizations are declining during the coronavirus pandemic, according to researchers from the University of Pennsylvania and Corporal Michael J. Crescenz US Department of Veterans Affairs Medical Center in Philadelphia. They found a “clear drop-off” among patients who ordinarily would meet acute care criteria.
Using data from the Veterans Outcomes and Costs Associated with Liver Disease (VOCAL) cohort, the researchers collected data that included length of stay, type of hospital, and region for 7,216 patients and 12,467 hospitalizations between January 1 and April 15 in 2019 and 2020. They designated 3 2020 subgroups: pre-COVID (before February 29), early COVID (February 29 - March 25), and late COVID (March 26 - April 15). The breakpoints were chosen because the Veterans Health Administration announced a COVID-19 Response Plan on March 23 that was implemented widely within 3 days.
Analyzing the differences in data from the 2 years, the researchers found weekly cirrhosis hospitalizations were on average 159.5 fewer in the late-COVID era, while admissions for end-stage liver disease were significantly higher. Patients also had shorter lengths of stay in 2020 when compared with 2019 (median, 2 days vs 3), and fewer hospital transfers (7.5% vs 11.1%).
The late-COVID era also was characterized by significantly fewer academic hospital admissions (63.6% vs 68.1% pre-COVID). And more patients were discharged to home in the late-COVID era (91.1% vs 88.8% pre-COVID) and fewer to facilities (5.1% vs 9.0% pre-COVID).
The changes likely reflect initiatives to preserve inpatient resources, the researchers say. “Importantly,” they suggest, their findings probably “parallel changes in other inpatient resource-intensive conditions,” such as congestive heart failure, chronic obstructive pulmonary disease, and myocardial infarction.
The pandemic response also may be sending conflicting messages to people who already have serious illnesses: Patients may be following guidance encouraging them to stay home, or avoiding going to the hospital until their symptoms are severe, perhaps from fears about COVID-19.
It is unclear how these patients are being managed, the researchers add. “Given the baseline vulnerability of patients with cirrhosis, it is likely that many do not currently have adequate healthcare access.”