COVID-19 hospital designation: Effect on emergency department patient self-selection and volume

Abstract

Objective: Combating Coronavirus 2019 has stretched hospital resources to the extreme. In an effort to cohort personnel and equipment, NorthShore University HealthSystem (NSUHS) designated Glenbrook Hospital (GBH) as our “COVID hospital”, which became public knowledge on April 6, 2020. We hypothesize that with this public declaration our emergency department (ED) total volumes and COVID-19 related visits would be affected.
Methods: We performed a retrospective analysis of our total ED volumes and COVID-19 related ED visits from March 12, 2020 until April 30, 2020. The pre public declaration timeframe of March 12-April 5, 2020 acted as our control whereas the post-public declaration acted as the testing group (April 6-April 30, 2020). NSUHS four primary hospitals were included in the analysis. We ran a chi-squared analysis on both groups to determine if there was statistical significance.
Results: Both total ED volumes and COVID-19 related ED visits, when comparing pre VS post-public declaration of GBH as the “COVID hospital”, showed statistical significance (p < .001). Three of the four hospitals had a decrease in total ED volumes, whereas the COVID-19 related ED visits increased at two hospitals and decreased at the others.
Conclusions: Our results support our hypothesis that after the public declaration of Glenbrook Hospital as the “COVID hospital”, patients’ decision making regarding which ED to visit was significantly affected. Certain limitations, including socioeconomic status and a small geographical footprint of NSUHS, may have affected our results. Further work should be done to reproduce these results to ensure replication.