Colorado Study tracks long-term use of Covid health care

Colorado Study tracks long-term use of Covid health care

A new study analyzing long-term Covid health care utilization in Colorado shows a significant shift from acute care to outpatient services after diagnosis, shedding light on evolving treatment patterns and the broader health burden posed by the disease.

The study, published today inBMC public healthwas conducted using the comprehensive database for the All-Zayer facility in Colorado and provides one of the most detailed population-level insights into long Covid patients to date. Researchers examined the usage patterns of people diagnosed with long Covid between October 2021 and August 2022 and tracked them for a year after diagnosis.

The study highlights the significant burden that long Covid places on healthcare systems and emphasizes the need for robust data and comprehensive care models. Understanding these usage patterns can help policymakers and healthcare providers effectively allocate resources and design interventions that meet the unique needs of long Covid patients. “

Rick Devoss, MPH, study co-author and graduate student at the Colorado School of Public Health, University of Colorado Anschutz Medical Campus

Out of a population of approximately 3.9 million, 26,358 (0.67%) people were diagnosed with long Covid, which equated to 674 cases per 100,000 people.

“This collaboration between the state and the University of Colorado Anschutz Medical Campus is a critical step in understanding the long-term impact of Covid-19 on our communities,” said Rachel Herlihy, MD, MPH, Colorado State Epidemiologist. "By leveraging insurance data, we can uncover key insights into healthcare utilization, costs and patient outcomes, ultimately guiding policy and improving care for those affected by Long Covid. This research is a testament to the power of government and academic partnerships in combating public health challenges."

The researchers observed a significant shift in healthcare usage with this data. Before diagnosis, 17% of patients experienced at least one hospitalization and 40% had visited an emergency department. After diagnosis, hospital stays decreased by 6.1 percentage points (PP) and emergency department visits decreased by 7.7 (PP) compared to matched controls. In contrast, outpatient office visits increased by 3.6 (PP), specialty visits increased by 4.7 (PP), and new medication prescriptions increased.

“These results suggest that receiving a long Covid diagnosis, often associated with a multidisciplinary long Covid clinic and Long Covid-aware providers, can enable more treatment options and greater validation of lived experiences for patients with Long Covid,” says Sarah Jolley, MD. Co-author of the study and director of the UCHealth post-Covid clinic/ICU. “This trend highlights the importance of timely diagnosis and coordinated care strategies to improve patient outcomes,” she continued.

“This is a critical step in understanding the long-term health care needs of this patient population and similar groups affected by post-viral diseases that are difficult to diagnose and treat due to the constellation of symptoms and organs,” Associate Professor at the Colorado School of Public Health and study co-author. “In addition, the all-payer claims database, which contains data from approximately 75% of the state population, allows us to capture a more robust representation of the entire population, rather than drawing from anonymized electronic health records from a few select health systems.”

This research used the International Classification of Diseases (ICD-10) U09.9 code to identify long Covid cases and provides a new lens through which to view the healthcare needs associated with the condition. Patients diagnosed with long Covid were compared with similar patients without the disease to account for changes in healthcare delivery during the pandemic years.

The study also found that some diagnosed conditions such as advanced cancer changed similarly in long Covid patients and controls, suggesting that the impact of changes in usage that affected the entire population during the pandemic period was taken into account.

“Long Covid is disabling and can be psychologically damaging,” says Dr. Perraillon. "When you're tired, in pain and can't sleep, it's very hard to function. Quality of life and productivity suffer and, like similar conditions, are difficult to diagnose, patients go from doctor to doctor or the emergency department to find relief and answers. Some also receive the additional diagnosis of chronic fatigue syndrome."

This research is part of a larger project to examine usage patterns, costs and outcomes among patients diagnosed with long Covid and those who are likely to have the condition but have not received a diagnosis.

The research would not have been possible without funding from the Office of Saving People Money on Health Care, the Colorado School of Public Health Initiative, Dean funding, the Colorado Department of Public Health and Environment, and others. Additionally, it illustrates the important work that can be accomplished through improved collaborations between state agencies and the university.

“This study illustrates the power of collaboration between state agencies and our world-class research institutions,” said Dianne Primavera, Lt. Governor of Colorado and Director of the Office of People Money for Health Care. "By collaborating with the University of Colorado Anschutz Medical Campus, we are deepening our understanding of Long Covid's impact on our population and improving our ability to support Coloradans affected by this condition. Partnerships like this are important to advance data-driven policies that advance this condition. Improve public health and ensure our health care system meets the evolving needs." can meet needs. “

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