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

Smulowitz, Peter B.; O’Malley, A. James; Khidir, Hazar; Zaborski, Lawrence; McWilliams, J. Michael; Landon, Bruce E.

doi:10.1377/hlthaff.2021.00561

Cited by 25 publications

(25 citation statements)

References 16 publications

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“…17 One US study included over 23 million emergency department (ED) visits for elderly Medicare beneficiaries, and compared hospital admission rate and changes in 30-day mortality between identical periods in 2018-19 and 2019-20. 18 The drop in ED visits and increase in admission rate didn’t correlate with local COVID-19 incidence. Mortality risk after ED visits also increased.…”

Section: Discussionmentioning

confidence: 96%

“…Furthermore, the lack of correlation with COVID-19 incidence suggests that patient behaviours (rather than hospital capacity) were responsible. 18 Another US study found a decrease in ED visits for serious cardiovascular conditions early in the pandemic with gradual recovery (until October 2020) 19 . The same drop in cardiovascular visits was seen in Europe.…”

Section: Discussionmentioning

confidence: 99%

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Temporal trends in hospitalizations and 30-day mortality in older patients during the COVID pandemic from March 2020 to July 2021

García-Ptacek

Annetorp

et al. 2021

Preprint

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Importance: Previous reports have suggested reductions in mortality risk from COVID-19 throughout the first wave of the COVID-19 pandemic. Mortality changes later in the pandemic and pandemic effects on other types of geriatric hospitalizations are less studied. Objectives: To describe the changes in hospitalizations and 30-day mortality in Stockholm for patients 70+ receiving inpatient geriatric care for COVID-19 and other causes. Design: Observational study. For patients 70 or older, we present the incidence of 30-day mortality from COVID-19 in the Stockholm region, in relationship to geriatric hospitalizations and 30-day mortality after admission for COVID-19 and other causes. Setting: Hospitalizations for patients 70+ from geriatric clinics in Stockholm, Sweden hospitalized for COVID-19 or other causes between March 2020 and July 31, 2021, were included. Participants: The total number of geriatric hospitalizations for patients 70+ was 5,320 for COVID-19 and 32,243 for non-COVID-19 causes, corresponding to 4,565 individual COVID-19 patients and 19,308 non-COVID-19 patients. Exposure(s): The date of hospital admission to a geriatric clinic. Main Outcome(s) and Measure(s): 30-day mortality after admission. Results: In patients with COVID-19, the 30-day mortality rate was highest at the beginning of the first wave (29% in March-April 2020), decreased as the first wave subsided (7% July-August), increased again in the second wave (17% November-December), but failed to increase as much in the third wave (11-13% March-July 2021). In non-COVID-19 geriatric patients during the same period, the 30-day mortality presented a similar trend, but with a smaller magnitude of variation (5 to 10%). The number of persons 70 or older testing positive for COVID-19 in Stockholm reached two peaks in 2020 (April and December), fell in January 2021 and then increased again in March-April 2021. Conclusions and Relevance: During the first and second waves, hospital admissions and 30-day mortality after geriatric hospitalization for COVID-19 increased in periods of high community transmission, although the mortality peak was lower in wave 2 than in wave 1. The mortality for non-COVID geriatric cases was lower and more stable but also showed an increase with the pandemic peaks.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Temporal trends in hospitalizations and 30-day mortality in older patients during the COVID pandemic from March 2020 to July 2021

García-Ptacek

Annetorp

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…The difference-in-differences design accounts for decreases in acute care visits related to external factors, such as public health guidance. 13 , 14 We then used AMEs to estimate the association of practice telehealth use during the pandemic with the rate of ACSC visits. Because our prepandemic and postpandemic measurement periods only span 4 months, these associations were annualized to report the estimated rate of ACSC visits per 1000 patients per year.…”

Section: Methodsmentioning

confidence: 99%

Association Between Primary Care Practice Telehealth Use and Acute Care Visits for Ambulatory Care–Sensitive Conditions During COVID-19

Zhu

et al. 2022

JAMA Netw Open

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Key Points Question What is the association between a primary care practice’s degree of telehealth use and acute care visits for ambulatory care–sensitive conditions during the COVID-19 pandemic? Findings In this cohort study with a difference-in-differences analysis of insurance claims data from 4038 primary care practices, high primary care telehealth use was associated with 2.10 more emergency department visits or hospitalizations for ambulatory care–sensitive conditions per 1000 patients per year compared with the practices with the least telehealth use. Meaning These findings suggest that high levels of primary care practice telehealth use may result in slightly higher acute care visits for ambulatory care–sensitive conditions.

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“…7 Moreover, several national and local studies showed similar declines in ED utilization during March-April 2020. 1,2,8,9 Currently, no studies have provided nationally representative estimates of the effect of the COVID-19 pandemic on injury ED visits in the U.S. since the declaration of the pandemic. The COVID-19 pandemic has affected the ways that many individuals interact and behave owing to public health prevention strategies implemented to slow the spread of COVID-19, such as stay-at-home orders, social 4 distancing, school closures, and canceling of large gatherings.…”

Section: Introductionmentioning

confidence: 99%

Injury-Related Emergency Department Visits During the COVID-19 Pandemic

Law

Wolkin

Patel

et al. 2022

American Journal of Preventive Medicine

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

Cited by 25 publications

References 16 publications

Temporal trends in hospitalizations and 30-day mortality in older patients during the COVID pandemic from March 2020 to July 2021

Temporal trends in hospitalizations and 30-day mortality in older patients during the COVID pandemic from March 2020 to July 2021

Association Between Primary Care Practice Telehealth Use and Acute Care Visits for Ambulatory Care–Sensitive Conditions During COVID-19

Injury-Related Emergency Department Visits During the COVID-19 Pandemic

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