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COVID-19-Related Downscaling of In-Hospital Liver Care Decreased Patient Satisfaction and Increased Liver-Related

Lukas Hartl1,2, Georg Semmler1,2, Benedikt Silvester Hofer1,2,3

  • 1Division of Gastroenterology and HepatologyDepartment of Medicine IIIMedical University of ViennaViennaAustria.

Hepatology Communications
|July 5, 2021
PubMed

Insights

The COVID-19 pandemic reduced patient satisfaction and access to care, leading to sicker patients with advanced liver disease being hospitalized. This resulted in increased liver-related mortality, highlighting the need for better telemedicine and proactive cirrhosis management.

Area of Science:

  • Hepatology
  • Public Health
  • Telemedicine

Background:

  • The COVID-19 pandemic led to reduced in-hospital care to prevent severe acute respiratory syndrome-coronavirus-2 transmission.
  • This study investigates the pandemic's impact on liver care quality and patient outcomes in Austria.

Purpose of the Study:

  • To assess patient perceptions of care quality during COVID-19 restrictions.
  • To analyze trends in hospital admissions (elective and non-elective) before and during the pandemic.
  • To evaluate the impact on patients with cirrhosis.

Main Methods:

  • Two patient cohorts were surveyed on care quality via telesurvey and written questionnaires.
  • Hospital admission data from December 2019 to May 2020 were analyzed.
  • Patient-reported satisfaction, access to care, and clinical outcomes (including mortality) were assessed.

Main Results:

  • Patient satisfaction with treatment decreased significantly in one cohort.
  • Contacting physicians was difficult or impossible for over half of patients needing acute care.
  • Despite fewer admissions, non-elective and intensive care unit admissions increased.
  • Patients with cirrhosis admitted non-electively had higher MELD scores, required more intensive care, and had increased 30-day mortality.

Conclusions:

  • COVID-19 restrictions negatively impacted liver care quality, evidenced by lower patient satisfaction and increased mortality.
  • Hospitalized patients with advanced chronic liver disease were sicker during the pandemic.
  • Improved telemedical liver care and preemptive management of cirrhosis complications are crucial to mitigate the effects of restricted in-hospital care.

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