Recent CarePort webinars led by Tom Martin, Director of Post-Acute Analytics focused on the “new normal” for acute and post-acute care amidst the COVID-19 pandemic. Below, we discuss the impact of COVID-19 on hospital readmissions following care at both the acute and post-acute levels, and how CarePort can help your organization reduce hospital readmissions by better tracking patients across the continuum during the COVID-19 pandemic – and beyond.
Acute care: hospital-wide readmissions during COVID-19
Among CarePort customers in New York – a market where CarePort is well-represented –readmissions typically hovered between 16% and 20% for patients over 65 years old despite some week-to-week fluctuations. During the peak of the COVID-19 pandemic in March and April, however, CarePort data shows a dip in readmission rates. We suspect the reasoning behind this decline is in part due to the fact that readmissions prior to the pandemic were unnecessary, and patients that normally would have readmitted postponed their return to the hospital for fear of contracting COVID-19. This was further supported in CarePort data showing that patients admitted between March and June were sicker on average, as measured by their average Elixhauser comorbidity index.
In this market, CarePort data also showed a similar rate of 30-day hospital readmissions between COVID-19 and non-COVID-19 patients after controlling for age. Controlling for age is important when measuring the readmission rates for the COVID-19 population as these patients, on average, tend to be much older.
Post-acute care: SNF rehospitalization and mortality rates during COVID-19
The critical quality measure used across post-acute settings is the 30-day rehospitalization rate. For CarePort’s SNF partners, readmission rates for short stay SNF patients climbed during the COVID-19 pandemic. The post-acute population – specifically, a SNF’s custodial population – are particularly vulnerable to COVID-19. Mortality rates, even among the short stay population, also experienced a dramatic increase during the pandemic.
High-level takeaways: How COVID-19 is impacting readmissions
COVID-19 patients’ risk of readmission is associated with age: Unsurprisingly, COVID-19 patients are older – over the age of 65 – and age is strongly correlated with risk of readmission.
Certain conditions and comorbidities are associated with an increased risk of readmission: Several chronic conditions that have historically been predictors of readmissions for non-COVID-19 patients are also strong predictors of readmission risk for COVID-19 patients.
When a COVID-19 patient readmits, it happens fast: Most COVID-19 patients are readmitted within the first week following discharge (median is 3 days), and the chance of readmission decreases the longer a COVID-19 patient has been out of the hospital. CarePort data indicates that 62% of COVID-19 patients are readmitted with the U07.1 MDC code, indicating a COVID-19 complication such as respiratory infection or circulatory condition.
HRRP rates have been impacted by the COVID-19 pandemic: CarePort examined readmission rates for chronic condition cohorts that CMS uses for their Hospital Readmissions Reduction Program (HRRP), and found that across all customers – and in patient populations over the age of 65 – the direct readmission rate was lower for most cohorts during the pandemic. We suspect readmission rates will return to pre-pandemic levels, but require further follow-up data.