Change in urban and non-urban pattern of ED use during the COVID-19 pandemic in 28 Michigan hospitals: an observational study

Abstract

ObjectiveTo assess the trends in visits, overall and by age, to urban and non-urban emergency departments (EDs), and visits resulting in admission to hospital before and during the COVID-19 pandemic using a large regional database.SettingA large regional database of 28 EDs during the COVID-19 pandemic in Michigan, with an index case of 11 March 2020 and peak in the first week of April.ParticipantsED visits during the first 5 months of the calendar year were included and compared with the previous year. Facilities where these participants were seen were classified as urban or non-urban, with comparisons of total visits, COVID-like cases, paediatric and trauma.Outcome measuresDaily visits to EDs of patients presenting with COVID-like symptoms, trauma, age patterns and total cases, and stratified between urban and non-urban settings.ResultsThere were 1 732 852 visits across the 2 years, 953 407 between study and comparison periods, and 457 130 visits defined as COVID-like (median age 44 years). Total ED visits decreased to 48% of the previous year, showing a delayed-inverse relationship with COVID-19. Trauma cases dropped but returned to the pre-COVID-19 rate by the end of May in Urban centres. Paediatric cases decreased to 20% of the previous year by the end of April. The oldest age groups showed the least change in ED visits in response to the pandemic.ConclusionsThis large US Midwestern state study describes a dramatic decrease in ED visits after the onset of the COVID-19 pandemic in Michigan, including stratification by varying ages and trauma, demonstrating the tangible impact of the COVID-19 pandemic on urban and non-urban EDs.

The impact of the COVID-19 pandemic on paediatric health service use within one year after the first pandemic outbreak in New South Wales Australia – a time series analysis

“…A dramatic decrease in non-COVID-19 related paediatric health service use within the first six months of the COVID-19 pandemic has been documented across multiple countries. 1 , 2 , 3 , 4 This followed the introduction of public health strategies, such as social lockdown measures, promotion of social distancing and good hygiene practices, to control the spread of SARS-CoV-2. This reduction in health service use has been shown to have both positive and negative impacts on child and adolescent health.…”

Trends in Health Service Use for Canadian Adults With Dementia and Parkinson Disease During the First Wave of the COVID-19 Pandemic

“…[4][5][6] In the pandemic's early stages, hospitals discharged individuals to prepare for patients with COVID-19, 7 surgical procedures were canceled, 8 and individuals were hesitant to visit emergency departments. 9,10 In the home care setting, clients canceled in-home visits owing to transmission fears, and clinicians faced barriers to care provision, including a lack of access to personal protective equipment and safe transportation. [11][12][13] The COVID-19 pandemic has been particularly devastating in the nursing home setting, with high mortality rates [14][15][16] prior to vaccine distribution.…”

Is sobriety from alcohol necessary for evaluation of patients presenting with suicidal ideation?

“…During the COVID-19 pandemic, increases in depression and suicide have been reported, especially in the adolescent age range, less so among adults (Santomauro, D. et al 2021) (Yard E. et al 2021). In addition, presentations for alcohol intoxication increased substantially during the pandemic (Keyes, Hardin et al 2021). For this reason, it may be important to examine the impact of sobriety on the diagnosis of suicidality prior to the pandemic when it can be evaluated in its more natural context.…”