Exploring the Changes in Code Status During the COVID-19 Pandemic and the Implications for Future Pandemic Care

Area of Science:

• Medical research
• Public health
• Healthcare policy

Background:

• The COVID-19 pandemic significantly impacted healthcare systems globally.
• Understanding changes in patient care preferences, such as code status, is crucial during public health crises.
• Palliative care services play a vital role in end-of-life care and symptom management.

Purpose of the Study:

• To compare inpatient code status and palliative care utilization during the COVID-19 pandemic versus a pre-pandemic period.
• To identify factors influencing code status decisions in hospitalized patients during the pandemic.
• To assess the demand for palliative care services amidst the pandemic.

Main Methods:

• Retrospective cohort study analyzing inpatient data from Montefiore Health System.
• Comparison of admissions between March 15-May 31, 2019, and March 15-May 31, 2020.
• Logistic regression analysis to determine predictors of full code status.

Main Results:

• Total inpatient admissions decreased during the pandemic.
• A significantly lower proportion of patients had full code status during the pandemic (85.1% vs. 94%).
• Palliative care consultations saw a 20% relative increase, and intubated patients were less likely to be full code.

Conclusions:

• The proportion of full code patients decreased significantly during the COVID-19 pandemic.
• Patient age and COVID-19 status were key determinants of code status.
• There was an increased demand for palliative care services during the pandemic.