Heart failure & cardiomyopathiesResearch article
Healthcare System Resilience and Adaptation: A 6-Year Analysis of Heart Failure Care in the Veterans Affairs System
- interrupted time series analysis
- linear regression models with monthly fixed effects
Authors' conclusion
Heart failure with reduced ejection fraction medication rates for Veterans were generally sustained or improved during the study period, but care gaps remain. Telehealth replaced some in-person primary and specialty care early in the pandemic, and in-person primary care has sustained at lower rates than before the pandemic. The rate of hospitalization sustained at lower levels while mortality has increased.
Study context
- Population
- Veterans with heart failure with reduced ejection fraction in the Veterans Health Administration (VA) healthcare system, January 1, 2019 to December 31, 2024individuals (mean age, 73.1 years, 2.2% women, mean ejection fraction, 32.8%)
- Participants
- 210,535 veterans
- Comparison
- care patterns across prepandemic, early COVID, and late COVID periods
Main finding
As reported in the abstract
Upward trends for most medications in the early COVID period and for all medications in the late COVID period, percentage point increase per 6-week period, compared with pre-COVID baseline (range)
0.1-0.9
Further findings
Telehealth utilization · onset of COVID
- primary care
- 12.4 [95% CI, 9.5-15.2] percentage points
- cardiology
- 5.5 [95% CI, 4.5-6.5] percentage points
- 2- to 4-fold increase
All-cause hospitalization, heart failure hospitalization, mortality · pandemic onset
- relative decrease in all-cause hospitalization, compared with pre-COVID baseline
- 31%
- relative decrease in heart failure hospitalization, compared with pre-COVID baseline
- 27%
- increase in mortality, compared with pre-COVID baseline
- 13%
Original publication
Summarised from the published abstract; every number is checked against it