# Influence of Healthcare Delivery Type on Patients’ Mental Health: Is Hospitalization Always a Stressful Factor? Can Allostatic Load Help Assess a Patient’s Psychological Disorders?

## TL;DR

The study found that outpatient COVID-19 patients had higher anxiety levels than hospitalized patients, suggesting hospitalization may not always be a stressor.

## Contribution

The study introduces a novel approach to assessing psychological distress in pandemic settings by comparing hospitalization and outpatient care.

## Key findings

- Outpatient patients had significantly higher Tension-Anxiety scores than hospitalized patients.
- 36.9% of outpatient patients exhibited anxiety symptoms.
- Allostatic load was not correlated with psychological alterations in patients.

## Abstract

Background: Psychological distress is a predictor of future health and disease data, with consequent implications for both the patient and the healthcare system. Taking advantage of the unprecedented situation caused by the COVID-19 pandemic we aimed to assess whether the type of medical care received by patients during the initial months of the pandemic influenced their evolution, particularly at the psychological level. Additionally, we investigated whether allostatic load was associated not only with physical but also psychological alterations. Methods: All the patients diagnosed with COVID-19 infection at HM Madrid Hospital during the month of March 2020 were studied, both those hospitalized (110) and those treated on an outpatient basis (46). They were psychologically evaluated using the Profile of Mood States (POMS) test. We calculated the allostatic load using different laboratory parameters. Results: Outpatient patients had significantly higher scores than hospitalized ones in Tension-Anxiety (52 ± 19.3 vs. 38 ± 4.3; p < 0.001). So, 36.9% of the outpatient patients exhibited anxiety. Allostatic load has not been correlated with patients’ psychological alterations. Conclusions: Psychological distress of outpatient patients should be taken into account in their management to improve mental health planning. This knowledge could provide comprehensive care to patients including their mental health, in the face of subsequent epidemics/pandemics.