Trends in hospital discharge outcomes among high-risk Medicare beneficiaries before and during the COVID-19 pandemic

• DOI: 10.1093/haschl/qxaf056
• Publication Date: 2025-03-18T10:04:03Z
• Authors: Anthony I Roberts; Christopher M San...; Zihan Chen; Brian E McGarry; Elizabeth M White; Linda J Resnik; Fangli Geng; David C Grabowski; Momotazur Rahman
• Keywords: Pandemic; Home health; Stroke

Abstract Introduction Medicare beneficiaries face significant health risks and care disruptions during public emergencies, but little is known about how patterns evolved throughout the COVID-19 pandemic or differed between traditional (TM) Advantage (MA). Methods Using claims data for over 20 million hospital discharges 2018-2022, we examined trends in length of stay, discharge disposition, mortality among with five major comorbidities (dementia, diabetes, congestive heart failure, hip fracture, stroke), stratified by COVID status payer type. Results We found that patients initially experienced substantially longer stays (8.3 vs 4.6 days) higher 30-day (34% 5%) compared to without COVID. MA showed consistently home utilization similar TM enrollees. By mid-2022, most outcome differences had converged non-COVID patients, suggesting system adaptation pandemic. Conclusion Our findings highlight was associated shifts towards home-based post-acute care, emphasizing need policies supporting infrastructure flexible delivery models could help systems better adapt future emergencies.