Abstract Rationale Older Veterans remain disproportionately affected by post-acute sequelae of COVID-19 (long COVID). Within the South Texas Veterans Health Care System (STVHCS) Geriatrics and Extended Care, we developed the Holistic Older Veterans Program for Enduring Long COVID care (HOPE), a longitudinal, multidisciplinary, telehealth-enabled model. This study evaluated the clinical effectiveness of HOPE on 1-year mortality among older Veterans and assessed participants’ perceptions of care quality. Methods A clinical innovation project was conducted at STVHCS between March 2020 and July 2024. All Veterans who survived the acute phase of COVID-19 were universally offered enrollment in HOPE; those who accepted participation comprised the HOPE group, while those who declined constituted the comparison group (non-HOPE). Groups were compared using age-based matching. The primary outcome was 1-year all-cause mortality. For patient perception, we randomly selected 30 HOPE participants and administered a mailed survey in June-July 2025 using Likert scales (1=strongly disagree to 5=strongly agree) assessing quality of care, staff support, information usefulness, telehealth effectiveness, care access, and overall health impact. Qualitative data from open-ended survey comments were thematically analyzed to identify key themes. Results The effectiveness cohort included 4,655 Veterans (n = 925 HOPE vs. n = 3,730 non-HOPE). One-year all cause-mortality was 0.76% (7/925) among HOPE participants versus 3.91% (146/3,730) among non-HOPE Veterans. HOPE participation was associated with substantially lower 1-year mortality (OR 0.19, 95% CI 0.09-0.41; p 0.0001). The absolute risk difference was −3.15 percentage points (number needed to treat = 32). Twenty (66%) Veterans responded to the “Veteran Feedback Survey on Long COVID”. Favorable ratings were obtained at 86% for quality of care, staff support, and information usefulness; 79% for telehealth effectiveness; 64% for care access; and 57% for overall health impact. For the perception question (“How else can we improve the Long COVID Program?”), 14 of 20 Veterans responded (70%) with a high internal consistency (Cronbach α = 0.86). Qualitative analysis revealed three key themes: (1) validation of symptoms and experiences as real through empathetic listening, (2) the critical importance of sustained longitudinal contact for this chronic condition, and (3) opportunities to enhance individualized care approaches and accessibility. Conclusion In this non-randomized comparison, HOPE participation was associated with substantially reduced 1-year mortality and highly positive patient perceptions across most domains. Lower ratings for care access and overall health impact identify opportunities for program optimization. Prospective controlled studies should confirm survival benefit and refine patient-centered access. This abstract is funded by: None
Trinh et al. (Fri,) studied this question.