• Cuiling Wei, VincentThe University of Hong Kong., Ka Chun Yan, Camille Maringe, RachelThe University of Hong Kong., Yui Ki Chu, Wenlong Liu, Boyan Liu, Yuqi Hu, Lingyue Zhou, CelineThe University of Hong Kong., Sze Ling Chui, Xue Li, EricUniversity of Hong Kong., Yuk Fai Wan, Ching Lung Cheung, EstherUniversity of Hong Kong., Wai Yin Chan, WilliamThe University of Hong Kong., Chi Wai Wong, IanUniversity of Hong Kong., Chi Kei Wong, and Francisco Lai.
• The University of Hong Kong.
• Br J Gen Pract. 2024 Jun 20; 74 (suppl 1).

BackgroundOlder adults with multimorbidity are at high risk of mortality following COVID-19 hospitalisation. However, the potential benefit of timely primary care follow-up on severe outcomes post-COVID-19 has not been well established.AimTo examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged ≥85 years, with multimorbidity.MethodWe emulated a target trial using a comprehensive public healthcare database in Hong Kong. The cloning-censoring-weighting technique was used to minimise immortal time bias and confounding bias by adjusting for demographics, hospitalisation duration and ICU admission, baseline chronic conditions, and medication history. The outcome included all-cause and cause-specific mortality.ResultsOf 6183 eligible COVID-19 survivors, the all-cause mortality rate following COVID-19 hospitalisation was lower in general out-patient clinics (GOPC) group compared to non-GOPC group (17.1 versus 42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI = 8.1% to 14.4%). We also observed better survival from respiratory diseases in the GOPC group. In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a GOPC visit after COVID-19 discharge, the better the survival.ConclusionTimely primary care consultations after discharge may improve survival following COVID-19 hospitalisation among older adults aged ≥85 years, with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population's recovery and well-being.© British Journal of General Practice 2024.

16 keywords...

hide…