Patients’ evaluation of aftercare following hospitalization for COVID-19: satisfaction and unmet needs
Authors: Berentschot Julia C. , de Ridder Willemijn A. , Bek L. Martine , Heijenbrok-Kal Majanka H. , Braunstahl Gert-Jan , Remerie Sylvia C. , Stuip Yvonne , Ribbers Gerard M. , Aerts Joachim G. J. V. , Ista Erwin , Hellemons Merel E. , van den Berg-Emons Rita J. G. ,   the CO-FLOW Collaboration Group, Bindraban Sieshem , Blox Wouter J. B. , van Bommel Jasper , Gajadin Shai A. , van Genderen Michel E. , Gommers Diederik A. M. P. J. , van Loon-Kooij Stephanie , Osterthun Rutger , Oswald Laurien , van Rossem Ronald N. , van de Sande Herbert J. , van der Stoep Robert , Tazmi-Staal Janette J. , Luijkx Chantal J. C. , Wijffels Markus P. J. M. , Willems Eva G. 
Published: March 2024

Abstract
Background
Patient experiences with COVID-19 aftercare remain largely unknown. We evaluated COVID-19 aftercare from a patient perspective one year after hospitalization, assessing satisfaction and its associated factors, and unmet needs.

Methods
The Satisfaction with COVID-19 Aftercare Questionnaire (SCAQ) was developed as part of a multicenter prospective cohort study and administered one year after hospital discharge. The SCAQ assesses (1) patient satisfaction, comprising information provision, rehabilitation, follow-up by hospitals and general practitioners (GPs), the most important aftercare topics, and overall satisfaction, and (2) unmet needs.

Results
487/561 (87%) COVID-19 patients completed the SCAQ, all had been discharged from the hospital between March 2020 and May 2021. Among responders, the median age of patients was 60 (IQR 54–67) years, 338 (69%) were male, and the median length of stay in the hospital was 13 (6–27) days. Patients were least satisfied with information on who could be contacted with questions when health problems arise (59% satisfied or very satisfied). Many patients (75%) received rehabilitation, most frequently community-based (70%). Across the different community-based therapies, ≥ 60% of patients were satisfied with shared-decision making and ≥ 70% with the received therapy; a majority (≥ 79%) indicated a preference for receiving the same therapy again if needed. Regarding follow-up by hospitals, 86% of patients received this follow-up, most frequently visiting a pulmonologist (96%), being generally satisfied with the received aftercare. Aftercare from GPs was received by 39% of patients, with 88% being satisfied with the GP’s availability and 79% with referral to appropriate aftercare providers. Patients (> 50%) considered information-related items most important in aftercare. Overall, patients rated their satisfaction with aftercare 8/10 (7–9) points. Those who received medical rehabilitation (versus no rehabilitation, adjusted beta 0.61 [95%CI 0.11 to 1.11], p = 0.02) or aftercare by a hospital medical specialist (1.1 [0.46 to 1.64], p < 0.001) or GP (0.39 [0.053 to 0.72], p = 0.023) reported significantly higher satisfaction than those without such aftercare. Unmet needs were reported by 35% of patients, with lack of information (20%) and lack of additional aftercare and/or involvement of their GP (19%) being the most frequently reported.

Conclusion
Despite the forced quick development of COVID-19 aftercare, patients were generally satisfied. Follow-up by healthcare professionals and information provision is important to meet patients’ aftercare needs.