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Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US

IMPORTANCE: As coronavirus disease 2019 (COVID-19) spread throughout the US in the early months of 2020, acute care delivery changed to accommodate an influx of patients with a highly contagious infection about which little was known. OBJECTIVE: To examine trends in emergency department (ED) visits...

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Autores principales: Jeffery, Molly M., D’Onofrio, Gail, Paek, Hyung, Platts-Mills, Timothy F., Soares, William E., Hoppe, Jason A., Genes, Nicholas, Nath, Bidisha, Melnick, Edward R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400214/
https://www.ncbi.nlm.nih.gov/pubmed/32744612
http://dx.doi.org/10.1001/jamainternmed.2020.3288
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author Jeffery, Molly M.
D’Onofrio, Gail
Paek, Hyung
Platts-Mills, Timothy F.
Soares, William E.
Hoppe, Jason A.
Genes, Nicholas
Nath, Bidisha
Melnick, Edward R.
author_facet Jeffery, Molly M.
D’Onofrio, Gail
Paek, Hyung
Platts-Mills, Timothy F.
Soares, William E.
Hoppe, Jason A.
Genes, Nicholas
Nath, Bidisha
Melnick, Edward R.
author_sort Jeffery, Molly M.
collection PubMed
description IMPORTANCE: As coronavirus disease 2019 (COVID-19) spread throughout the US in the early months of 2020, acute care delivery changed to accommodate an influx of patients with a highly contagious infection about which little was known. OBJECTIVE: To examine trends in emergency department (ED) visits and visits that led to hospitalizations covering a 4-month period leading up to and during the COVID-19 outbreak in the US. DESIGN, SETTING, AND PARTICIPANTS: This retrospective, observational, cross-sectional study of 24 EDs in 5 large health care systems in Colorado (n = 4), Connecticut (n = 5), Massachusetts (n = 5), New York (n = 5), and North Carolina (n = 5) examined daily ED visit and hospital admission rates from January 1 to April 30, 2020, in relation to national and the 5 states’ COVID-19 case counts. EXPOSURES: Time (day) as a continuous variable. MAIN OUTCOMES AND MEASURES: Daily counts of ED visits, hospital admissions, and COVID-19 cases. RESULTS: A total of 24 EDs were studied. The annual ED volume before the COVID-19 pandemic ranged from 13 000 to 115 000 visits per year; the decrease in ED visits ranged from 41.5% in Colorado to 63.5% in New York. The weeks with the most rapid rates of decrease in visits were in March 2020, which corresponded with national public health messaging about COVID-19. Hospital admission rates from the ED were stable until new COVID-19 case rates began to increase locally; the largest relative increase in admission rates was 149.0% in New York, followed by 51.7% in Massachusetts, 36.2% in Connecticut, 29.4% in Colorado, and 22.0% in North Carolina. CONCLUSIONS AND RELEVANCE: From January through April 2020, as the COVID-19 pandemic intensified in the US, temporal associations were observed with a decrease in ED visits and an increase in hospital admission rates in 5 health care systems in 5 states. These findings suggest that practitioners and public health officials should emphasize the importance of visiting the ED during the COVID-19 pandemic for serious symptoms, illnesses, and injuries that cannot be managed in other settings.
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spelling pubmed-74002142020-08-13 Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US Jeffery, Molly M. D’Onofrio, Gail Paek, Hyung Platts-Mills, Timothy F. Soares, William E. Hoppe, Jason A. Genes, Nicholas Nath, Bidisha Melnick, Edward R. JAMA Intern Med Original Investigation IMPORTANCE: As coronavirus disease 2019 (COVID-19) spread throughout the US in the early months of 2020, acute care delivery changed to accommodate an influx of patients with a highly contagious infection about which little was known. OBJECTIVE: To examine trends in emergency department (ED) visits and visits that led to hospitalizations covering a 4-month period leading up to and during the COVID-19 outbreak in the US. DESIGN, SETTING, AND PARTICIPANTS: This retrospective, observational, cross-sectional study of 24 EDs in 5 large health care systems in Colorado (n = 4), Connecticut (n = 5), Massachusetts (n = 5), New York (n = 5), and North Carolina (n = 5) examined daily ED visit and hospital admission rates from January 1 to April 30, 2020, in relation to national and the 5 states’ COVID-19 case counts. EXPOSURES: Time (day) as a continuous variable. MAIN OUTCOMES AND MEASURES: Daily counts of ED visits, hospital admissions, and COVID-19 cases. RESULTS: A total of 24 EDs were studied. The annual ED volume before the COVID-19 pandemic ranged from 13 000 to 115 000 visits per year; the decrease in ED visits ranged from 41.5% in Colorado to 63.5% in New York. The weeks with the most rapid rates of decrease in visits were in March 2020, which corresponded with national public health messaging about COVID-19. Hospital admission rates from the ED were stable until new COVID-19 case rates began to increase locally; the largest relative increase in admission rates was 149.0% in New York, followed by 51.7% in Massachusetts, 36.2% in Connecticut, 29.4% in Colorado, and 22.0% in North Carolina. CONCLUSIONS AND RELEVANCE: From January through April 2020, as the COVID-19 pandemic intensified in the US, temporal associations were observed with a decrease in ED visits and an increase in hospital admission rates in 5 health care systems in 5 states. These findings suggest that practitioners and public health officials should emphasize the importance of visiting the ED during the COVID-19 pandemic for serious symptoms, illnesses, and injuries that cannot be managed in other settings. American Medical Association 2020-10 2020-08-03 /pmc/articles/PMC7400214/ /pubmed/32744612 http://dx.doi.org/10.1001/jamainternmed.2020.3288 Text en Copyright 2020 Jeffery MM et al. JAMA Internal Medicine. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Jeffery, Molly M.
D’Onofrio, Gail
Paek, Hyung
Platts-Mills, Timothy F.
Soares, William E.
Hoppe, Jason A.
Genes, Nicholas
Nath, Bidisha
Melnick, Edward R.
Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
title Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
title_full Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
title_fullStr Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
title_full_unstemmed Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
title_short Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
title_sort trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the covid-19 pandemic in the us
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400214/
https://www.ncbi.nlm.nih.gov/pubmed/32744612
http://dx.doi.org/10.1001/jamainternmed.2020.3288
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