Evidence map›Paper›PMID 40190700›Full record

ArticleHealth affairs scholar2025

Trends in hospital discharge outcomes among high-risk Medicare beneficiaries before and during the COVID-19 pandemic.

Anthony I Roberts, Christopher M Santostefano, Zihan Chen, Brian E McGarry, Elizabeth M White, Linda J Resnik, Fangli Geng, David C Grabowski, Momotazur Rahman

Abstract read
In one paragraph

Article in Health affairs scholar, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Anthony I RobertsDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI 02903, United States.ORCID https://orcid.org/0000-0002-2165-1246
Christopher M SantostefanoDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI 02903, United States.
Zihan ChenDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI 02903, United States.
Brian E McGarryDivision of Geriatrics and Aging, Department of Medicine, University of Rochester, Rochester, NY 14642, United States.ORCID https://orcid.org/0000-0001-5342-6548
Elizabeth M WhiteDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI 02903, United States.
Linda J ResnikDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI 02903, United States.ORCID https://orcid.org/0000-0002-0168-6759
Fangli GengDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI 02903, United States.ORCID https://orcid.org/0000-0002-7399-8612
David C GrabowskiDepartment of Health Care Policy, Harvard Medical School, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0003-2915-5770
Momotazur RahmanDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI 02903, United States.ORCID https://orcid.org/0000-0002-8592-3511

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Medicare beneficiaries face significant health risks and care disruptions during public health emergencies, but little is known about how care patterns evolved throughout the COVID-19 pandemic or differed between traditional Medicare (TM) and Medicare Advantage (MA). Methods: Using Medicare claims data for over 20 million hospital discharges during 2018-2022, we examined trends in hospital length of stay, discharge disposition, and mortality among beneficiaries with 5 major comorbidities (dementia, diabetes, congestive heart failure, hip fracture, and stroke), stratified by COVID status and payer type. Results: We found that COVID patients initially experienced substantially longer hospital stays (8.3 vs 4.6 days) and higher 30-day mortality (34% vs 5%) compared to patients without COVID. MA beneficiaries showed consistently higher home health utilization but similar mortality patterns to TM enrollees. By mid-2022, most outcome differences had converged between COVID and non-COVID patients, suggesting health system adaptation to the pandemic. Conclusion: Our findings highlight how the pandemic was associated with shifts toward home-based post-acute care, emphasizing the need for policies supporting home-based care infrastructure and flexible care delivery models that could help health systems better adapt during future public health emergencies.

Indexed as

comorbiditiesCOVID-19home health carehospital discharge outcomeslength of stayMedicareMedicare Advantagemortalitypost-acute careskilled nursing facilitiesTraditional Medicare

Identifiers

PMID40190700
PMCPMC11970246

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.