Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study.

Publication date: Nov 08, 2024

Healthcare policy implemented during the COVID-19 pandemic may have impacted the health of patients with heart failure. Australian data provide a unique opportunity to examine service disruption independent of significant COVID-19 burden. This study aimed to examine heart failure care during the pandemic in New South Wales (NSW). Analysis of hospital utilisation among patients aged ≥ 18 years with a primary diagnosis of heart failure conducted using linked administrative health records from hospital admission, emergency department, non-admitted services, and mortality data collections. Health service utilisation and outcomes were compared “Pre-pandemic” (PP): 16th March 2018 – 28th August 2019 and “During pandemic” (DP): 16th March 2020 – 28th August 2021. Mortality data were available until December 2021. Heart failure-related ED presentations and hospital admissions were similar between the periods (PP = 15,324 vs DP = 15,023 ED presentations, PP = 24,072 vs DP = 23,145 hospital admissions), though rates of admission from ED were lower DP (PP = 12,783/15,324 (83. 4% [95% CI 82. 8-84. 0]) vs DP = 12,230/15,023 (81. 4% [95% CI 80. 8-82. 0%]). There was no difference according to age, sex, rurality, or socioeconomic status. Outpatient volume reduced DP (PP = 44,447 vs DP = 35,801 occasions of service), but telehealth visits increased nearly threefold (PP = 5,978/44,447 (13. 4% [95% CI 13. 1-13. 8%]) vs DP = 15,901/35,801 (44. 4% [95% CI 43. 9-44. 9%]) with highest uptake among the wealthy and those in major cities. Time to heart failure-related ED presentation, hospitalisation or all-cause mortality following index admission was longer DP (PP = 273 [IQR 259, 290] days, DP = 323 [IQR 300, 342] days, HR 0. 91 [95% CI 0. 88, 0. 95]). Policies implemented DP had minimal impact on volumes of inpatient heart failure care in NSW hospitals, but there were fewer admissions from ED and reduced volumes of publicly funded outpatient care. A rapid shift from patient-facing to remotely delivered care enabled compliance with restrictions and was associated with increased time to heart failure-related adverse events, but access was not afforded equally across the socio-demographic spectrum.

Open Access PDF

Concepts Keywords
Australia Adult
December Aged
Outpatient Aged, 80 and over
Cohort Studies
COVID-19
COVID-19
Emergency Service, Hospital
Female
Health service utilisation
Heart Failure
Heart failure
Hospitalization
Humans
Male
Middle Aged
New South Wales
Pandemics
SARS-CoV-2

Semantics

Type Source Name
disease MESH COVID-19 pandemic
disease MESH heart failure
disease MESH emergency
pathway REACTOME Reproduction
disease IDO history
disease MESH sequelae
drug DRUGBANK Medical air
disease IDO quality
disease MESH infection
disease MESH morbidity
drug DRUGBANK Trestolone
disease MESH death
disease MESH chronic diseases
disease MESH cancer
disease MESH obesity
disease MESH depression
disease MESH anxiety
disease MESH hypertension
disease MESH chronic obstructive pulmonary disease
disease MESH asthma
pathway KEGG Asthma
disease MESH Diabetes mellitus
disease MESH Sleep disorders
disease MESH Primary hypertension
disease MESH Myocardial infarction
disease MESH Atrial fibrillation
disease MESH Ischemic stroke
disease MESH Chronic bronchitis
drug DRUGBANK Indoleacetic acid
disease MESH home environments
disease MESH viral load
disease IDO process
drug DRUGBANK Serine
drug DRUGBANK Hexachlorophene
disease MESH myocarditis
drug DRUGBANK Oxygen
disease MESH vascular disease
disease MESH cardiovascular disease
disease MESH coronary heart disease
disease MESH respiratory infections

Original Article

(Visited 1 times, 1 visits today)