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Impact of the COVID-19 Pandemic on Inpatient Utilization for Acute Neurologic Disease

Alexander Yoo1, Elan L Guterman2, David Y Hwang3

  • 1Department of Medicine, University of Pennsylvania Perlman School of Medicine, Philadelphia, PA, USA.

The Neurohospitalist
|January 18, 2024
PubMed

Insights

The COVID-19 pandemic saw fewer neurologic hospitalizations, with the greatest declines in headache cases. However, procedures for severe neurologic conditions like stroke and those requiring mechanical ventilation increased during this period.

Area of Science:

  • Neurology
  • Public Health
  • Epidemiology

Background:

  • The Corona Virus 2019 (COVID-19) pandemic initially led to a reduction in hospitalizations across various medical fields.
  • Understanding the impact on neurologic conditions is crucial for healthcare planning.

Purpose of the Study:

  • To analyze changes in hospitalization rates and procedures for neurologic diseases during the early COVID-19 pandemic.
  • To identify specific neurologic conditions with the most significant changes in admission rates.

Main Methods:

  • Retrospective observational study using the California State Inpatient Database.
  • Comparison of neurologic hospitalization rates and procedure utilization between a control period (Jan 2019-Feb 2020) and the pandemic period (Mar-Dec 2020).
  • Negative binomial regression used to calculate incident rate ratios (IRR) for hospitalizations.

Main Results:

  • Overall monthly neurologic hospitalizations decreased by 13% during the pandemic (IRR 0.87).
  • Headache admissions saw the largest decrease (IRR 0.62), while neurotrauma and neuro-oncologic cases had smaller declines.
  • Rates of endovascular thrombectomy for ischemic stroke, gastrostomy, intubation/mechanical ventilation, and tracheostomy increased during the pandemic.

Conclusions:

  • The early COVID-19 pandemic was associated with reduced hospitalizations for most neurologic diagnoses.
  • There was a concurrent increase in procedures indicative of severe disease among hospitalized neurologic patients.
  • Further research is needed to assess the long-term effects on patient outcomes and healthcare costs.

Keywords:
COVID-19epidemiology < techniquesneurohospitalist < clinical specialtytrendsutilization

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