Baseline characteristics of individuals discharged from inpatient acute care during the study period in Ontario, stratified by time period (before and after the onset of the COVID-19 pandemic)
| Characteristic | Prepandemic hospitalization (June 1, 2019, to Feb. 29, 2020) | Std. diff. (ALC v. no ALC status prepandemic) | Post–pandemic onset hospitalization (Mar. 1, 2020, to Nov. 30, 2020) | Std. diff. (ALC v. no ALC status post–pandemic onset) | Std. diff. (pre- v. post-onset, ALC status)* | Std. diff. (pre- v. post-onset, no ALC status)* | ||
|---|---|---|---|---|---|---|---|---|
| ALC status* | No ALC status* | ALC status* | No ALC status* | |||||
| No. of discharges | 116 490 | 2 239 938 | 38 200 | 737 781 | ||||
| Age, yr | ||||||||
| Mean ± SD | 76.9 ± 14.6 | 48.7 ± 29.3 | 1.22 | 77.3 ± 14.3 | 48.1 ± 29.3 | 1.27 | 0.02 | 0.02 |
| Median (IQR) | 80 (70–87) | 56 (28–73) | 80 (70–88) | 54 (28–73) | ||||
| Sex, no. (%) | ||||||||
| Female | 63 059 (54.1) | 1 249 285 (55.8) | 0.04 | 20 729 (54.3) | 411 799 (55.8) | 0.03 | 0 | 0 |
| Male | 53 418 (45.9) | 985 392 (44.0) | 17 468 (45.7) | 323 867 (43.9) | ||||
| Neighbourhood income, no. (%) | ||||||||
| 1 (lowest) | 33 223 (28.5) | 524 392 (23.4) | 0.12 | 11 080 (29.0) | 171 589 (23.3) | 0.13 | 0.01 | 0 |
| 2 | 26 051 (22.4) | 462 455 (20.7) | 0.04 | 8589 (22.5) | 151 669 (20.6) | 0.05 | 0 | 0 |
| 3 | 21 553 (18.5) | 441 593 (19.7) | 0.03 | 7016 (18.4) | 145 546 (19.7) | 0.04 | 0 | 0 |
| 4 | 18 120 (15.6) | 413 747 (18.5) | 0.08 | 5886 (15.4) | 136 104 (18.5) | 0.08 | 0 | 0 |
| 5 (highest) | 16 752 (14.4) | 379 049 (16.9) | 0.07 | 5344 (14.0) | 124 742 (16.9) | 0.08 | 0.01 | 0 |
| Rural, no. (%) | ||||||||
| No | 103 115 (88.5) | 1 939 265 (86.6) | 0.06 | 33 873 (88.7) | 638 610 (86.6) | 0.06 | 0.01 | 0.01 |
| Yes | 12 614 (10.8) | 283 004 (12.6) | 4052 (10.6) | 91 372 (12.4) | ||||
| Comorbidities, no. (%) | ||||||||
| 0 | 1802 (1.6) | 516 580 (23.1) | 0.69 | 560 (1.5) | 183 181 (24.8) | 0.74 | 0.01 | 0 |
| 1 | 3645 (3.1) | 241 640 (10.8) | 0.30 | 1112 (2.9) | 79 129 (10.7) | 0.31 | 0.01 | 0 |
| 2 | 6828 (5.9) | 257 164 (11.5) | 0.20 | 2163 (5.7) | 84 443 (11.5) | 0.21 | 0.01 | 0 |
| 3 | 11 256 (9.7) | 252 870 (11.3) | 0.05 | 3543 (9.3) | 82 317 (11.2) | 0.06 | 0 | 0.01 |
| 4 | 14 885 (12.8) | 235 582 (10.5) | 0.07 | 4931 (12.9) | 75 370 (10.2) | 0.08 | 0.02 | 0.03 |
| ≥ 5 | 78 074 (67.0) | 736 102 (32.9) | 0.73 | 25 891 (67.8) | 233 341 (31.6) | 0.78 | 0.01 | 0.02 |
| No. of unique drugs† | ||||||||
| Mean ± SD | 10.3 ± 8.0 | 4.7 ± 7.5 | 0.72 | 10.4 ± 8.0 | 4.6 ± 7.4 | 0.76 | 0.01 | 0.02 |
| Hospital harm,‡ no. (%) | ||||||||
| No. of harm admissions | 13 179 (11.3) | 62 241 (2.8) | 0.34 | 2954 (7.7) | 17 377 (2.4) | 0.25 | 0.12 | 0.03 |
| Health care or medications | 7531 (6.5) | 33 351 (1.5) | 0.26 | 1650 (4.3) | 9646 (1.3) | 0.18 | 0.10 | 0.02 |
| Infections | 7148 (6.1) | 18 986 (0.9) | 0.29 | 1659 (4.3) | 4932 (0.7) | 0.24 | 0.08 | 0.02 |
| Patient accidents | 893 (0.8) | 1797 (0.1) | 0.11 | 200 (0.5) | 512 (0.1) | 0.08 | 0.03 | 0 |
| Procedure | 1509 (1.3) | 19 851 (0.9) | 0.04 | 303 (0.8) | 5886 (0.8) | 0 | 0.05 | 0.01 |
| Hospital Frailty Score | ||||||||
| Mean ± SD | 8.1 ± 5.2 | 1.6 ± 2.8 | 1.57 | 8.4 ± 5.3 | 1.7 ± 3.0 | 1.57 | 0.05 | 0.04 |
| Low risk (< 5), no. (%) | 37 535 (32.2) | 2 008 347 (89.7) | 1.46 | 11 448 (30.0) | 651 866 (88.4) | 1.48 | 0.05 | 0.04 |
| Moderate risk (5–15), no. (%) | 66 456 (57.1) | 219 235 (9.8) | 1.16 | 22 246 (58.2) | 81 018 (11.0) | 1.14 | 0.02 | 0.04 |
| High risk (> 15), no. (%) | 12 499 (10.7) | 12 356 (0.6) | 0.45 | 4506 (11.8) | 4897 (0.7) | 0.47 | 0.03 | 0.01 |
| Type of admission, no. (%) | ||||||||
| Planned elective | 12 721 (10.9) | 661 301 (29.2) | 0.48 | 4283 (11.2) | 203 713 (27.6) | 0.43 | 0.01 | 0.04 |
| Unplanned | 103 769 (89.1) | 1 578 637 (70.5) | 33 917 (88.8) | 534 068 (72.4) | ||||
| Major clinical category, no. (%) | ||||||||
| Surgical | 27 009 (23.2) | 673 359 (30.1) | 0.15 | 8163 (21.4) | 212 304 (28.8) | 0.17 | 0.04 | 0.03 |
| Medical | 89 481 (76.8) | 1 566 579 (69.9) | 30 037 (78.6) | 525 477 (71.2) | ||||
Note: ALC = alternate level of care, IQR = interquartile range, SD = standard deviation, Std. Diff. = standardized difference.
↵* Standardized differences comparing characteristics of those with ALC status pre– and post–pandemic onset, as well as among those with non-ALC status.
↵† Number of unique drugs in the year before observation window for those eligible in the Ontario Drug Benefit Program.
↵‡ Hospital harm as per the Canadian Institute for Health Information Hospital Harm Index.