Table 2. Healthcare utilization and mortality following a delayed discharged in acute care, stratified by discharge destination and time period (pre vs onset of COVID-19), Ontario, Canada.
| Home (with or without support) | Inpatient Rehabilitation | Long-Term Carea | |||||||
|---|---|---|---|---|---|---|---|---|---|
| n = 21164 | n = 25504 | n = 12120 | |||||||
| Outcomes | Pre† | Post/Onset †† | Std. Diff | Pre | Post/Onset | Std. Diff | Pre | Post/Onset | Std. Diff |
| Mortality post index discharge, n (%) | |||||||||
| Within 30 days | 912 (6.28) | 440 (6.63) | 0.01 | 1578 (8.89) | 677 (8.74) | 0.01 | 814 (9.04) | 322 (10.33) | 0.04 |
| Within 90 days | 1955 (13.46) | 927 (13.96) | 0.01 | 2685 (15.12) | 1104 (14.25) | 0.02 | 1510 (16.77) | 584 (18.73) | 0.05 |
| Acute Hospital Re-admissions | |||||||||
| Within 7 days post discharge (index admission), Mean (SD) | 0.07 (0.27) | 0.07 (0.27) | 0.01 | 0.03 (0.18) | 0.03 (0.17) | 0.01 | 0.04 (0.19) | 0.05 (0.22) | 0.05 |
| Within 30 days post discharge (index admission), Mean (SD) | 0.21 (0.48) | 0.21 (0.48) | 0.00 | 0.12 (0.36) | 0.12 (0.35) | 0.00 | 0.11 (0.35) | 0.13 (0.37) | 0.04 |
| Emergency Department Visits | |||||||||
| Within 30 days post index discharge, Mean (SD) | 0.21 (0.67) | 0.19 (0.72) | 0.03 | 0.08 (0.33) | 0.08 (0.33) | 0.02 | 0.11 (0.39) | 0.09 (0.36) | 0.05 |
| Physician Visits 30 Days Post Index Discharge | |||||||||
| Primary care physician visits | |||||||||
| Mean (SD) | 1.04 (1.63) | 1.47 (2.06) | 0.23 | 1.92 (3.86) | 1.91 (3.69) | 0.00 | 2.39 (3.22) | 1.99 (2.78) | 0.13 |
| Median (IQR) | 1 (0–1) | 1 (0–2) | 0 (0–2) | 0 (0–2) | 1 (0–3) | 1 (1–2) | |||
| Specialist visits | |||||||||
| Mean (SD) | 0.6 (1.07) | 0.71 (1.22) | 0.10 | 0.81 (1.53) | 0.86 (1.57) | 0.03 | 0.43 (1.05) | 0.32 (0.83) | 0.12 |
| Median (IQR) | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0 (0–0) | |||
| Physician Visits 90 Days Post Index Discharge | |||||||||
| Primary care physician visits | |||||||||
| Mean (SD) | 2.5 (3.56) | 3.32 (4.44) | 0.20 | 4.47 (7.78) | 4.55 (7.24) | 0.01 | 5.41 (6.09) | 4.46 (4.92) | 0.17 |
| Median (IQR) | 2 (0–3) | 2 (1–4) | 2 (1–4) | 2 (1–5) | 3 (2–6) | 3 (2–5) | |||
| Specialist visits | |||||||||
| Mean (SD) | 1.65 (2.48) | 1.82 (2.66) | 0.07 | 2.23 (3.07) | 2.45 (3.24) | 0.07 | 1.11 (2.21) | 0.75 (1.53) | 0.19 |
| Median (IQR) | 1 (0–2) | 1 (0–3) | 1 (0–3) | 2 (0–3) | 0 (0–2) | 0 (0–1) | |||
| Homecare visits | |||||||||
| Within 30 days post index discharge | |||||||||
| Mean (SD) | 15.46 (16.14) | 15.28 (16.41) | 0.01 | 1.89 (4.43) | 2 (4.65) | 0.03 | |||
| Median (IQR) | 9 (1–30) | 9 (0–30) | 0 (0–1) | 0 (0–2) | |||||
| Within 90 days post index discharge | |||||||||
| Mean (SD) | 38.3 (41.9) | 37.81 (42.35) | 0.01 | 15.32 (23.57) | 15.78 (23.97) | 0.02 | |||
| Median (IQR) | 20 (2–72) | 20 (2–70) | 3 (0–22) | 3 (0–23) | |||||
†Pre COVID-19: April 1 2019-Feb 29, 2020
††Post-COVID March 1-September 30
Abbreviations: Std. Diff = standardized difference; SD = standard deviation; IQR = interquartile range; GP/FP = general practitioner/family practitioner
a If patients were admitted to long-term care within 90 days post discharge then they were included in long-term care group.
Standardized differences were used to compare the populations admitted before and after COVID-19 onset. We considered differences unimportant when below 10% (0.1)