Impact of the SARS-CoV-2 Pandemic on Emergency Department Presentations in an Integrated Health System.

Abstract:

OBJECTIVE:To quantify the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on emergency department volumes and patient presentations and evaluate changes in community mortality for the purpose of characterizing new patterns of emergency care use. PATIENTS AND METHODS:This is an observational cross-sectional study using electronic health records for emergency department visits in an integrated multihospital system with academic and community practices across 4 states for visits between March 17 and April 21, 2019, and February 9 and April 21, 2020. We compared numbers and proportions of common and critical chief symptoms and diagnoses, triage assessments, throughput, disposition, and selected hospital lengths of stay and out-of-hospital deaths. RESULTS:In the period of interest, emergency department visits decreased by nearly 50% (35037 to 18646). Total numbers of patients with myocardial infarctions, stroke, appendicitis, and cholecystitis diagnosed decreased. The percentage of visits for mental health symptoms increased. There was an increase in deaths, driven by out-of-hospital mortality. CONCLUSION:Fewer patients presenting with acute and time-sensitive diagnoses suggests that patients are deferring care. This may be further supported by an increase in out-of-hospital mortality. Understanding which patients are deferring care and why will allow us to develop outreach strategies and ensure that those in need of rapid assessment and treatment will do so, preventing downstream morbidity and mortality.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Walker LE,Heaton HA,Monroe RJ,Reichard RR,Kendall M,Mullan AF,Goyal DG

doi

10.1016/j.mayocp.2020.09.019

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

2395-2407

issue

11

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(20)31052-1

journal_volume

95

pub_type

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