Objectives Australia is among the few, large jurisdictions to experience more than one pandemic wave proceeded by no incident COVID-19 cases. We aimed to estimate the immediacy, extent and duration of impact of those waves on initial admission and readmission rates. Methods We used single and controlled interrupted time-series designs, segmented regression analyses and linked administrative data from 2016 to 2021. Results Congestive heart failure (CHF) patients experienced immediate and sizable reductions in weekly acute, initial admissions of 26% and 16% for up to 3 to 5 months after the first and Delta waves in 2020 and 2021, respectively. Unplanned readmissions within 30-days declined by 2.30 and 3.59 percentage points (10 to 16% rate reduction) and remained lower than expected for more than 4 to 5 months after both waves. These reductions occurred after years of stability in these measures. Reductions commenced earlier than the WHO declaration in 2020 and coincided stay-at-home orders in 2021. There was no significant change in average length of stay. Conclusions Pandemic waves and restrictions in NSW resulted in rapid, sizable, and sustained reductions in initial admission and readmission rates among CHF patients suggesting that clinician, patient and/or family decisions reduce potentially preventable admissions as these decisions occurred before or at the time of public health declarations. Future studies should explore the potential impact of this reduction on health outcomes of patients with CHF.
Watson et al. (Mon,) studied this question.
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