Emergency department utilization during the COVID-19 pandemic

Abstract

Objective: Optimizing resource utilization is critical to reducing healthcare costs. Our study aims to review trends in overall patient volume, acuity, time of presentation, and use of resources in the emergency department (ED) during the COVID-19 pandemic.
Methods: We compared ED utilization from a 30-day period during the height of the COVID-19 pandemic (April 1, 2020-April 30, 2020) to the same 30-day period in the preceding calendar year (April 1, 2019-April 30-2019). Data were grouped into outcome measures focusing on ED throughput and utilization of ancillary ED services.
Results: While the absolute number of patients in or arriving to the ED at any given time was significantly lower during the COVID-19 pandemic (p < .01), the hourly patterns of patient census, arrivals, and admissions all aligned with pre-pandemic values. Also, patient acuity, as measured by ESI level, did not significantly change. The absolute number of admissions for both
sites was similar to the pre-pandemic time period, but the percentage of patients admitted over the 30-day period increased. The absolute number of radiographic and laboratory studies ordered in the ED also changed significantly (p < .05), but the hourly pattern did not.
Conclusions: Our study shows significantly lower patient volumes, increased admission rates, and no significant change in the hourly throughput of the ED. Thus, our analysis suggests that shift times should not be adjusted, nor should the number or composition of providers on each shift in academic and community ED sites during the COVID national lockdown.