Post-discharge Healthcare Usage and Costs From March 2020 Through the Omicron Surge for Individuals Hospitalized With COVID-19

Introduction: Despite the rise of post-COVID care centers, few studies exist that quantify the burden of patient healthcare usage and hospital costs after COVID-19 hospitalization. It is essential to target postCOVID follow-up care to the individuals who need it most, such that costs and emergencies are minimized and health and appointment attendance are optimized. Methods: This was a retrospective cohort comparison among four groups of 50 patients (200 total). Postdischarge healthcare utilization metrics were collected for individuals hospitalized with COVID-19 during the first four surges of the pandemic to compare how patients receive and seek care in the year after they contract COVID-19. A brief cost analysis was done to identify high-usage groups that could be targeted for intervention to decrease post-COVID hospitalization emergencies and burden. Results: Patients hospitalized during the Omicron surge were scheduled for the most specialist visits on average, significantly higher than average specialist visits in the Delta surge (p < 0.05). The Delta surge had significantly less specialty care and missed visits than all other surges (p < 0.05) and less primary care than the first two surges of the pandemic (p < 0.05). Patients with type 2 diabetes and asthma had the highest overall costs (p < 0.05). Females and Hispanic patients had the highest specialty and ED costs (p < 0.05). Conclusion: Each surge reflects a different approach to post-COVID care, with the Omicron surge demonstrating the heaviest usage overall, particularly with specialty visits. Increased specialty referrals may exacerbate rates of missed appointments, while primary care may lower emergency visits. Future approaches to post-COVID care design should identify patients at risk for emergencies and reinstate them with primary care.