School of Medicine Publications and Presentations
Document Type
Article
Publication Date
4-18-2023
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.
Recommended Citation
Mayer, M, Badesch, DB, Nielsen, KH, Kawut, S, Bull, T, Ryan, JJ, Sager, J, Mazimba, S, Hemnes, A, Klinger, J, Runo, J, McConnell, JW, De Marco, T, Chakinala, MM, Yung, D, Elwing, J, Kaplan, A, Argula, R, Pomponio, R, Peterson, R, Hountras, P. Impact of the COVID-19 pandemic on chronic disease management and patient reported outcomes in patients with pulmonary hypertension: The Pulmonary Hypertension Association Registry. Pulm Circ. 2023; 13:e12233. https://doi.org/10.1002/pul2.12233
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Publication Title
Pulm Circ.
DOI
10.1002/pul2.12233
Academic Level
faculty
Mentor/PI Department
Internal Medicine
Comments
© 2023 The Authors.