Journal article
Impact of the COVID-19 pandemic on chronic disease management and patient reported outcomes in patients with pulmonary hypertension: The Pulmonary Hypertension Association Registry
Pulmonary circulation, Vol.13(2), pp.e12233-n/a
04/01/2023
DOI: 10.1002/pul2.12233
PMCID: PMC10163321
PMID: 37159803
Abstract
To better understand the impact of the COVID-19 pandemic on the care of patients with pulmonary hypertension, we conducted a retrospective cohort study evaluating health insurance status, healthcare access, disease severity, and patient reported outcomes in this population. Using the Pulmonary Hypertension Association Registry (PHAR), we defined and extracted a longitudinal cohort of pulmonary arterial hypertension (PAH) patients from the PHAR's inception in 2015 until March 2022. We used generalized estimating equations to model the impact of the COVID-19 pandemic on patient outcomes, adjusting for demographic confounders. We assessed whether insurance status modified these effects via covariate interactions. PAH patients were more likely to be on publicly-sponsored insurance during the COVID-19 pandemic compared with prior, and did not experience statistically significant delays in access to medications, increased emergency room visits or nights in the hospital, or worsening of mental health metrics. Patients on publicly-sponsored insurance had higher healthcare utilization and worse objective measures of disease severity compared with privately insured individuals irrespective of the COVID-19 pandemic. The relatively small impact of the COVID-19 pandemic on pulmonary hypertension-related outcomes was unexpected but may be due to pre-established access to high quality care at pulmonary hypertension comprehensive care centers. Irrespective of the COVID-19 pandemic, patients who were on publicly-sponsored insurance seemed to do worse, consistent with prior studies highlighting outcomes in this population. We speculate that previously established care relationships may lessen the impact of an acute event, such as a pandemic, on patients with chronic illness.
Details
- Title: Subtitle
- Impact of the COVID-19 pandemic on chronic disease management and patient reported outcomes in patients with pulmonary hypertension: The Pulmonary Hypertension Association Registry
- Creators
- Megan Mayer - University of Colorado DenverDavid B. Badesch - University of Colorado DenverKelly H. Nielsen - University of Colorado DenverSteven Kawut - University of PennsylvaniaTodd Bull - University of Colorado DenverJohn J. Ryan - University of UtahJeffrey Sager - Cottage HealthSula Mazimba - University of VirginiaAnna Hemnes - Vanderbilt University Medical CenterJames Klinger - Rhode Island HospitalJames Runo - University of Wisconsin–MadisonJohn W. McConnell - Norton HealthcareTeresa De Marco - University of California San Francisco Medical CenterMurali M. Chakinala - Washington University in St. LouisDelphine Yung - University of WashingtonJean Elwing - University of Cincinnati Medical CenterAdolfo Kaplan - The University of Texas Rio Grande ValleyRahul Argula - Medical University of South CarolinaRaymond Pomponio - Colorado School of Public HealthRyan Peterson - Colorado School of Public HealthPeter Hountras - University of Colorado Denver
- Resource Type
- Journal article
- Publication Details
- Pulmonary circulation, Vol.13(2), pp.e12233-n/a
- DOI
- 10.1002/pul2.12233
- PMID
- 37159803
- PMCID
- PMC10163321
- NLM abbreviation
- Pulm Circ
- ISSN
- 2045-8932
- eISSN
- 2045-8940
- Publisher
- Wiley
- Number of pages
- 9
- Language
- English
- Date published
- 04/01/2023
- Academic Unit
- Biostatistics; Internal Medicine
- Record Identifier
- 9984914150602771
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