Emergency department visits fall by at least 40% during pandemic
Fewer emergency department visits mean decreased revenues for hospitals that are still treating high numbers of COVID-19 patients.
A new cross-sectional study published by Jama Internal Medicine found that during the first months of the COVID-19 pandemic, emergency department visits declined by about 40% to 60%.
The study also found that, while hospital admission rates were initially steady despite decreasing emergency department visits, these began to increase as the number of COVID-19 cases also rose.
TOP-LINE DATA
Researchers looked at emergency department visits in five states, including Connecticut, Massachusetts, New York, North Carolina and Colorado.
The largest decrease in visits came from New York, at 63.5%. The smallest decrease occurred in Colorado, where emergency department visits went down by 41.5%. In between those states were Massachusetts, Connecticut and North Carolina, with decreases of 57.4%, 48.9% and 46.5%, respectively.
As COVID-19 cases began to rise across the country, the hospitals used in this study saw their admission rates increase as well. The largest increase in admissions was 149% in New York, followed by 51.7% in Massachusetts, 36.2% in Connecticut, 29.4% in Colorado, and 22% in North Carolina.
METHODS
From January 1 to April 30, researchers looked at trends from 24 emergency departments and hospital admission rates for five health systems in different states.
Data was collected from Mount Sinai Health System in New York, Baystate Health in Massachusetts, University of Colorado Health, University of North Carolina Health and Yale New Haven Health in Connecticut.
WHY THIS MATTERS
These reductions could have occurred, according to researchers, because "individuals may have avoided seeking emergency care because of a fear of being exposed to COVID-19 in the [emergency department], concerns about the possibility of extended wait times, or a sense of civic responsibility to avoid using healthcare services that others may have needed."
As a result of this study, the researchers noted three main takeaways.
"First, practitioners and public health officials should emphasize the importance of continuing to visit the [emergency department] for serious symptoms, illnesses, and injuries that cannot be managed in other settings, such as telemedicine visits. Second, infection control measures that protect patients and staff are essential in the [emergency department] and other clinical settings. Third, public health authorities and health care systems should provide guidance and resources to help patients determine the best place to receive care as the available health care capacity changes during the pandemic," the authors wrote in the report.
THE LARGER TREND
This isn't the first study showing how COVID-19 has impacted emergency department visits. One report in the Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention reported a 42% decline in emergency department visits from April 2019 to April 2020.
Decreased visits mean decreased revenues for hospitals that are still having to manage the COVID-19 pandemic.
FAIR Health recently released a study that indicated in April, healthcare professional services declined 68% in utilization and 48% in revenue based on total estimated in-network amounts compared to April 2019 nationally.
Kaufman Hall's April Flash Report showed operating EBITDA margins fell to -19% despite federal funding from the CARES Act.
ON THE RECORD
"The findings suggest that clinicians and public health officials should emphasize to patients the importance of continuing to visit the emergency department for serious symptoms, illnesses, and injuries that cannot be managed in other clinical settings," the JAMA authors said.
Twitter: @HackettMallory
Email the writer: mhackett@himss.org
