{"subscriber":false,"subscribedOffers":{}} National Trends In ED Visits, Hospital Admissions, And Mortality For Medicare Patients During The COVID-19 Pandemic | Health Affairs

Research Article

COVID-19

National Trends In ED Visits, Hospital Admissions, And Mortality For Medicare Patients During The COVID-19 Pandemic

Affiliations
  1. Peter B. Smulowitz ([email protected]) is an associate professor of emergency medicine in the Department of Emergency Medicine at the University of Massachusetts Medical School, in Worcester, Massachusetts, and chief medical officer at Milford Regional Medical Center, in Milford, Massachusetts.
  2. A. James O’Malley is a professor of biomedical data science at the Dartmouth Institute for Health Policy and Clinical Practice and in the Department of Biomedical Data Science at the Geisel School of Medicine at Dartmouth, in Hanover, New Hampshire.
  3. Hazar Khidir is a fellow in the National Clinician Scholars Program, Department of Internal Medicine and Emergency Medicine, Yale University School of Medicine, in New Haven, Connecticut. He was an emergency medicine resident physician in the Harvard Affiliated Emergency Medicine Residency Program, Massachusetts General Hospital and Brigham and Women’s Hospital, in Boston, Massachusetts, when this work was performed.
  4. Lawrence Zaborski is a senior statistical programmer in the Department of Health Care Policy at Harvard Medical School, in Boston, Massachusetts.
  5. J. Michael McWilliams is the Warren Alpert Foundation Professor of Health Care Policy in the Department of Health Care Policy at Harvard Medical School and a professor of medicine and general internist at Brigham and Women’s Hospital.
  6. Bruce E. Landon is a professor of health care policy in the Department of Health Care Policy at Harvard Medical School and a professor of medicine and practicing internist at Beth Israel Deaconess Medical Center.
PUBLISHED:September 2021No Accesshttps://doi.org/10.1377/hlthaff.2021.00561

Abstract

Concerns about avoidance or delays in seeking emergency care during the COVID-19 pandemic are widespread, but national data on emergency department (ED) visits and subsequent rates of hospitalization and outcomes are lacking. Using data on all traditional Medicare beneficiaries in the US from October 1, 2018, to September 30, 2020, we examined trends in ED visits and rates of hospitalization and thirty-day mortality conditional on an ED visit for non-COVID-19 conditions during several stages of the pandemic and for areas that were considered COVID-19 hot spots versus those that were not. We found reductions in ED visits that were largest by the first week of April 2020 (52 percent relative decrease), with volume recovering somewhat by mid-June (25 percent relative decrease). These reductions were of similar magnitude in counties that were and were not designated as COVID-19 hot spots. There was an early increase in hospitalizations and in the relative risk for thirty-day mortality, starting with the first surge of the pandemic, peaking at just over a 2-percentage-point increase. These results suggest that patients were presenting with more serious illness, perhaps related to delays in seeking care.

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