Doctor and senior woman wearing facemasks during coronavirus and flu outbreak. Virus protection. COVID-2019..

A new study pinpoints how the COVID-19 pandemic affected the post-hospital discharge settings for people with Alzheimer’s disease and related dementias (ADRDs) between 2019 and 2021. Discharges to nursing homes fell, while going to home health agencies or straight home increased — but this varied based on different populations.

Differences in where people went for post-acute care already were documented before the pandemic based on different racial and socioeconomic groups. But investigators didn’t know how the pandemic affected transitions from hospitals.

That’s why researchers linked national data from 2019 through 2021 with infection data. The data covered 830,656 community-dwelling Medicare fee-for-service beneficiaries with ADRD who were hospitalized at least once between 2019 and 2021, according to the study published Wednesday in the Journal of the American Geriatrics Society. 

Discharges to nursing homes decreased while discharges to home healthcare and to homes without professional care went up during the pandemic. That trend was more significant for people who were eligible for Medicaid and Medicare, as well as those in minority groups. People who weren’t eligible for both programs were more likely to use home health compared to skilled nursing, while those with dual eligibility were more apt to be discharged directly to home, the authors noted.

Going to a nursing home was the most common destination for 43.1% of the people over the study duration, but it went from 48% in 2019 to 37.9% in 2020 and to 39.1% in 2021, the data showed. Of the participants, 33.9% went directly home over the study duration, from 33.9% in 2019, 32.1% in 2020 and to 35.5% in 2021; 23% used home healthcare during the study duration, from 19.9% in 2019 up to 26.6% in 2020 then down to 25.2% in 2021.

“The COVID-19 pandemic significantly impacted post-acute care for people with ADRD, especially among socioeconomically disadvantaged and racial and ethnic minoritized populations,” the authors wrote. “Future research is needed to understand if and how these transitions may have affected health outcomes.”

“Understanding the effects of a public health emergency on differences in PAC destinations among the ADRD populations identifies areas for future research and informs intervention efforts aimed at ensuring healthcare access and improving outcomes, regardless of individual race, ethnicity, and socioeconomic status,” the authors wrote.