患有多种疾病的老年人感染 COVID-19 和出现并发症的风险较高。很少有人研究过 COVID-19 后干预措施或护理模式在减少这些个体随后的不良后果方面的有效性。本研究旨在探讨在 COVID-19 出院后 30 天内到普通科门诊就诊对 85 岁或以上患有多种疾病的老年人的 1 年生存率的有效性。利用电子健康记录模拟随机目标试验的回顾性队列研究。我们研究使用了香港医院管理局和卫生署的数据，这些数据为研究提供了全面的电子健康记录、COVID-19确诊病例数据、基于人群的疫苗接种记录和其他个人特征。年龄85岁或以上患有多种疾病的成年人2020 年 1 月至 2022 年 8 月期间因 COVID-19 住院后出院的患者。与没有门诊就诊相比，在上次 COVID-19 出院后 30 天内到普通门诊就诊定义了暴露。主要结局是一年内的全因死亡率。次要结局包括呼吸系统、心血管和癌症原因造成的死亡率。分析中总共纳入了 6183 名符合条件的 COVID-19 幸存者。与非就诊组（每 100 人年 42.8 例死亡）相比，普通门诊就诊组（每 100 人年 17.1 例死亡）的 COVID-19 住院后全因死亡率较低。调整后，出院后 30 天内的初级保健咨询与显着较高的 1 年生存率相关（1 年生存率差异：11.2%，95% CI 8.1% 至 14.4%）。我们还观察到普通门诊就诊组的呼吸系统疾病生存率显着提高（1 年生存率差异：6.3%、95% CI 3.5% 至 8.9%）。在对不同宽限期长度的敏感性分析中，我们发现参与者在 COVID-19 出院后越早去普通门诊就诊，生存期就越好。在 COVID-19 住院后及时进行初级保健咨询可能会提高参与者在 COVID-19 住院后的生存率85 岁或以上患有多种疾病的老年人。扩大初级保健服务和实施后续机制对于支持这一弱势群体的康复和福祉至关重要。© 作者（或其雇主）2024。CC BY-NC 允许重复使用。禁止商业再利用。请参阅权利和权限。由英国医学杂志出版。

Older individuals with multimorbidity are at an elevated risk of infection and complications from COVID-19. Effectiveness of post-COVID-19 interventions or care models in reducing subsequent adverse outcomes in these individuals have rarely been examined. This study aims to examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged 85 years or above with multimorbidity.Retrospective cohort study emulating a randomised target trial using electronic health records.We used data from the Hospital Authority and the Department of Health in Hong Kong, which provided comprehensive electronic health records, COVID-19 confirmed case data, population-based vaccination records and other individual characteristics for the study.Adults aged 85 years or above with multimorbidity who were discharged after hospitalisation for COVID-19 between January 2020 and August 2022.Attending a general outpatient within 30 days of last COVID-19 discharge defined the exposure, compared to no outpatient visit.Primary outcome was all-cause mortality within one year. Secondary outcomes included mortality from respiratory, cardiovascular and cancer causes.A total of 6183 eligible COVID-19 survivors were included in the analysis. The all-cause mortality rate following COVID-19 hospitalisation was lower in the general outpatient visit group (17.1 deaths per 100 person-year) compared with non-visit group (42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI 8.1% to 14.4%). We also observed significantly better survival from respiratory diseases in the general outpatient visit group (difference in 1-year survival: 6.3%, 95% CI 3.5% to 8.9%). In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a general outpatient visit after COVID-19 discharge, the better the survival.Timely primary care consultations after COVID-19 hospitalisation may improve survival following COVID-19 hospitalisation among older adults aged 85 or above with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population's recovery and well-being.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.