Risk of Potentially Preventable Hospitalizations After COVID-19 Infection Among US Veterans

Abstract Number:

3614 

Submission Type:

Contributed Abstract 

Contributed Abstract Type:

Poster 

Participants:

Diana Govier (1), Meike Niederhausen (2), Yumie Takata (3), Alex Hickok (4), Mazhgan Rowneki (4), Holly McCready (4), Valerie Smith (5), Thomas Osborne (6), Edward Boyko (7), George Ioannou (8), Matthew Maciejewski (9), Elizabeth Viglianti (10), Amy Bohnert (10), Ann O'Hare (11), Theodore Iwashyna (12), Denise Hynes (4)

Institutions:

(1) Center to Improve Veteran Involvement in Care, VA Portland Health Care System,, Portland, OR, (2) Oregon Health & Science University University – Portland State University School of Public Health, Portland, OR, (3) College of Health, Oregon State University, Corvallis, OR, (4) Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, (5) Department of Medicine, Duke University, Durham, NC, (6) VA Palo Alto Health Care System, Palo Alto, CA, (7) Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, (8) Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, (9) Center of Innovation to Accelerate Discovery & Practice Transformation, VA Durham Health Care System, Durham, NC, (10) VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, (11) Center of Innovation for Veteran-Centered and Value-Driven Care,VA Puget Sound Health Care System, Seattle, WA, (12) School of Medicine, Johns Hopkins University, Baltimore, MD

Co-Author(s):

MEIKE NIEDERHAUSEN  
Oregon Health & Science University University – Portland State University School of Public Health
Yumie Takata  
College of Health, Oregon State University
Alex Hickok  
Center to Improve Veteran Involvement in Care, VA Portland Health Care System
Mazhgan Rowneki  
Center to Improve Veteran Involvement in Care, VA Portland Health Care System
Holly McCready  
Center to Improve Veteran Involvement in Care, VA Portland Health Care System
Valerie Smith  
Department of Medicine, Duke University
Thomas Osborne  
VA Palo Alto Health Care System
Edward Boyko  
Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System
George Ioannou  
Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System
Matthew Maciejewski  
Center of Innovation to Accelerate Discovery & Practice Transformation, VA Durham Health Care System
Elizabeth Viglianti  
VA Center for Clinical Management Research, VA Ann Arbor Health Care System
Amy Bohnert  
VA Center for Clinical Management Research, VA Ann Arbor Health Care System
Ann O'Hare  
Center of Innovation for Veteran-Centered and Value-Driven Care,VA Puget Sound Health Care System
Theodore Iwashyna  
School of Medicine, Johns Hopkins University
Denise Hynes  
Center to Improve Veteran Involvement in Care, VA Portland Health Care System

First Author:

Diana Govier  
Center to Improve Veteran Involvement in Care, VA Portland Health Care System,

Presenting Author:

Alex Hickok  
N/A

Abstract Text:

Potentially preventable hospitalizations (PPH) are used to measure health system performance. During the COVID-19 pandemic, disruptions to healthcare may have hindered disease treatment and increased the risk of PPH. Messaging to stay home when sick, as well as post-infection sequelae may have compounded risks among those with COVID-19. Using an emulated target trial design with monthly sequential trials, we compared risk of a PPH among 189,136 Veterans with COVID-19 between March 1, 2020, and April 30, 2021 and 943,084 matched uninfected comparators. The primary outcome was a first PPH in Veterans Health Administration (VHA) hospitals, or in community hospitals either paid by VHA or Medicare fee-for-service. Extended Cox models were used to examine adjusted hazard ratios (aHRs) of PPH among Veterans with COVID-19 and comparators during varying follow-up periods: 0-30, 0-90, 0-180, and 0-365 days. In total, 3.1% (3.8% of infected and 3.0% of comparators) of Veterans had a PPH during one-year follow-up. The risk of a PPH was greater among Veterans with COVID-19 than comparators in four follow-up periods: 0-30-day aHR=3.26; 0-90-day aHR=2.12; 0-180-day aHR=1.69; 0-395-day aHR=1.44.

Keywords:

emulated target trial|preventable hospitalization|extended Cox modelling|SARS-CoV-2|COVID-19|Veterans

Sponsors:

Section on Statistics in Epidemiology

Tracks:

Causal Inference

Can this be considered for alternate subtype?

Yes

Are you interested in volunteering to serve as a session chair?

No

I have read and understand that JSM participants must abide by the Participant Guidelines.

Yes

I understand that JSM participants must register and pay the appropriate registration fee by June 1, 2024. The registration fee is non-refundable.

I understand