Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity: a territory-wide target trial emulation.

Older individuals with multimorbidity are at an elevated risk of infection and complications from COVID-19. Effectiveness of post-COVID-19 interventions or care models in reducing subsequent adverse outcomes in these individuals have rarely been examined. This study aims to examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged 85 years or above with multimorbidity.
Retrospective cohort study emulating a randomised target trial using electronic health records.
We used data from the Hospital Authority and the Department of Health in Hong Kong, which provided comprehensive electronic health records, COVID-19 confirmed case data, population-based vaccination records and other individual characteristics for the study.
Adults aged 85 years or above with multimorbidity who were discharged after hospitalisation for COVID-19 between January 2020 and August 2022.
Attending a general outpatient within 30 days of last COVID-19 discharge defined the exposure, compared to no outpatient visit.
Primary outcome was all-cause mortality within one year. Secondary outcomes included mortality from respiratory, cardiovascular and cancer causes.
A total of 6183 eligible COVID-19 survivors were included in the analysis. The all-cause mortality rate following COVID-19 hospitalisation was lower in the general outpatient visit group (17.1 deaths per 100 person-year) compared with non-visit group (42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI 8.1% to 14.4%). We also observed significantly better survival from respiratory diseases in the general outpatient visit group (difference in 1-year survival: 6.3%, 95% CI 3.5% to 8.9%). In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a general outpatient visit after COVID-19 discharge, the better the survival.
Timely primary care consultations after COVID-19 hospitalisation may improve survival following COVID-19 hospitalisation among older adults aged 85 or above with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population’s recovery and well-being.

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Author

admin

View all posts

Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity: a territory-wide target trial emulation.

REFERENCES & ADDITIONAL READING

ABOUT THE EXPERTS

PW Weekly Newsletters

PODCAST

Leveraging Nonverbal Cues to Build Trust & Improve Patient Care

Resilience in Medicine: Sharing Practices Physicians Can Easily Adopt to Improve Well-Being

Strategies to Help Diagnosis NSCLC and the Benefits of a Team-Based Approach, Part 2

PW Weekly Newsletters

RELEVANT ARTICLES FOR YOU

Tailoring ROS1+ NSCLC Treatment: The Role of Biomarker Testing

The Role of the Multidisciplinary Team for ROS1+ NSCLC

The Role of Pharmacists in Oncology Care

Test Your Knowledge of ROS1+ NSCLC

Year In Review - Endometrial Cancer

Test Video Title

Client Title

Silence in Sikeston: Trauma Lives in the Body

How Minnesota Figures Into the Presidential Politics of Insulin Prices

PODCAST2

Leveraging Nonverbal Cues to Build Trust & Improve Patient Care

Resilience in Medicine: Sharing Practices Physicians Can Easily Adopt to Improve Well-Being

Strategies to Help Diagnosis NSCLC and the Benefits of a Team-Based Approach, Part 2

Follow Us

Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity: a territory-wide target trial emulation.

Author

REFERENCES & ADDITIONAL READING

ABOUT THE EXPERTS

PW Weekly Newsletters

EXPLORE MORE

PODCAST

PW Weekly Newsletters

RELEVANT ARTICLES FOR YOU

PODCAST2

Stay connected to the latest news with Physician’s Weekly