News: Higher mortality rates, lower hospital visit rates among Medicare patients during late pandemic, study shows

When comparing admissions late in the COVID-19 pandemic with pre-pandemic, mortality rates were elevated for Medicare beneficiaries who had cardiovascular risk factors or established cardiovascular disease, according to a study recently published in the JACC Journal. Despite that, hospital visit rates were lower and use of outpatient visits were higher during this period, Medscape Medical News reported.

The study included all Medicare fee-for-service and Medicare Advantage beneficiaries with cardiovascular risk factors (hypertension, diabetes mellitus, hyperlipidemia) or cardiovascular diseases (coronary heart disease, heart failure, atrial fibrillation, stroke) from January 2018 to December 2022. Researchers looked at acute care visits, outpatient visits, and all-cause mortality during the late pandemic, defined as January 2021 to July 2022, compared with the pre-pandemic period, defined as January 2018 to December 2019.

Researchers found that all-cause mortality saw a 25% rise during the late pandemic period and that these mortality surges tracked with national COVID-19 mortality. The greatest increase in all-cause mortality was observed among beneficiaries in the most socially vulnerable communities and those covered by Medicare Advantage.

In contrast, data showed that hospital visit rates dropped in the late pandemic period for both rural and urban beneficiaries, across all levels of social vulnerability, and in both fee-for-service and Medicare Advantage beneficiaries.

Though study authors state that they do not know the exact reason behind these patterns, they believe there are at least three contributing factors: biology, behavior, and system strain.

“The mortality that we see in the data matches up with COVID spikes more broadly; that tells me that the virus is triggering cardiovascular events in addition to causing respiratory problems,” Karen Joynt Maddox, MD, MPH, one of the study authors, told Medscape Medical News. “We kind of knew that from flu, but this raises lots of interesting questions about the impact of viruses on inflammation and cardiovascular disease.”

Editor’s note: To access Medscape Medical News’ coverage of this story, click here. To read the full study, click here.