Patient Volume and Dispositions in a VA Psychiatric Emergency Room During COVID-19

Mitchell, Lorena; Fuehrlein, Brian

doi:10.1007/s10597-021-00778-w

Cited by 9 publications

(17 citation statements)

References 4 publications

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“…They showed that the social restriction policies by the Yogyakarta and Jakarta governments had no significant impact on decreasing the number of patient visits at health care facilities in March-July 2020. A study conducted by Mitchell and Fuehrlein (2021) about patient volume and dispositions in the Veteran's Affairs Department at Yale-New Haven Hospital USA showed that there was a decrease in visits in March-August 2020, especially in April 2020. At that time, it coincided with the peak of covid-19 cases in the USA.…”

Section: Resultsmentioning

confidence: 99%

The Analysis of National Health Insurance for Hospital Daily Patient Visits During Covid-19 in Mother-Child Hospital “Putri” Surabaya, Indonesia

Susanti

Amalia

2022

APJMT

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Introduction: Covid-19 has made changes to health services in Indonesia. It occurs in the hospital service flow, so patients must adjust to the restrictions that apply in the hospital. National health insurance (JKN) in Indonesia provides public access to health services. The existence of health insurance should be the solution for patients who are willing to take advantage of health services. Meanwhile, in the covid-19 condition, health services are essential, so they have to get a lot of attention. Objective: The purpose of this study was to analyze National Health Insurance (JKN) patients before and during covid-19 in Mother-Child Hospital "Putri" Surabaya. Methods: This study used descriptive analysis of national health insurance hospital patient visits (both outpatient and inpatient) in Mother-Child "Putri" Hospital Surabaya. The data was taken twice, which is before covid-19, from January 2018 to February 2020, and during Covid-19 from March 2020 to December 2021. Result: The results showed that the trend of JKN patients before and during covid-19 was very different. Before covid-19, there was a tendency to see an increase in JKN patients. During COVID-19, the JKN patient was reduced. Conclusion: Covid-19 is one of the factors that affected the reduction of JKN patients in Mother-Child Hospital "Putri" Surabaya. Not only this hospital, but all health-care services.

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Section: Resultsmentioning

confidence: 99%

The Analysis of National Health Insurance for Hospital Daily Patient Visits During Covid-19 in Mother-Child Hospital “Putri” Surabaya, Indonesia

Susanti

Amalia

2022

APJMT

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“…During the peak of COVID‐19 our local VA saw a decline in PER visits compared to previous years, 5 possibly due to people delaying emergency substance use and mental health care. Reasons for presenting to the PER typically include substance use, psychosis, suicidality, homicidal ideation, and other psychiatric crises 5 …”

Section: Introductionmentioning

confidence: 87%

“…In addition, age, gender (sex assigned at birth), service‐connected status, marital status, and comorbid psychiatric diagnoses were recorded. Given the increase in social isolation and stress brought upon by the COVID‐19 outbreak, there was still reason to believe that acute emergency services might be needed by some of our most vulnerable patients 5 . We examined PER visits, which could be related to SUD and non‐SUD related psychiatric emergencies, as it is indicative of crisis care during this period when use of most emergency services declined steeply 5 …”

Section: Introductionmentioning

confidence: 99%

“…2 VA was fortunate to have already had a video telehealth platform (VA Video Connect [VVC]), though it was not yet commonly used as a primary treatment modality when COVID-19 hit the United States. 3 Despite telehealth availability, early stages of the pandemic were associated with decreased medical and psychiatric emergency room (PER) use 4,5 and significant drops in diagnosis, in-person visits, and non-emergency surgeries across medical fields. [6][7][8] During the peak of COVID-19 our local VA saw a decline in PER visits compared to previous years, 5 possibly due to people delaying emergency substance use and mental health care.…”

Section: Introductionmentioning

confidence: 99%

“…3 Despite telehealth availability, early stages of the pandemic were associated with decreased medical and psychiatric emergency room (PER) use 4,5 and significant drops in diagnosis, in-person visits, and non-emergency surgeries across medical fields. [6][7][8] During the peak of COVID-19 our local VA saw a decline in PER visits compared to previous years, 5 possibly due to people delaying emergency substance use and mental health care. Reasons for presenting to the PER typically include substance use, psychosis, suicidality, homicidal ideation, and other psychiatric crises.…”

Section: Introductionmentioning

confidence: 99%

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Treatment utilization and modality preference among veterans receiving outpatient substance use disorder treatment during a pandemic

et al. 2022

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Background and Objectives: This study examines substance use disorder (SUD) treatment utilization patterns in response to a pandemic. Method: Retrospective electronic medical record data were collected during three time periods (N = 390): "Pre-COVID-19" (12/02/2019-03/14/2020), "COVID-19" (03/15/2020-06/30/2020), and COVID-19 "Re-entry" (7/01/2020-10/01/2020). Number of visits in each time period, SUD diagnosis, treatment modality (video, telephone, none), demographic, and clinical variables were examined. One-way analyses of variance (ANOVA) and chi-square analyses tested the relationships between treatment modality, demographics, clinical variables, and psychiatric emergency room (PER) visits. Binary logistic regressions examined the effect of treatment modality on PER use during COVID-19 and Re-entry, controlling for alcohol, opioid, and cocaine use disorders, age, and past-year (pre-COVID-19) PER use.Results: Treatment modality was associated with SUD (alcohol, cocaine, opioids), age, and PER visits. Veterans who primarily attended telephone appointments were more likely to require PER services compared to those attending video appointments. In the full model, alcohol use disorder (AUD), past-year PER visits, and treatment modality (telephone visits) continued to be significantly associated with COVID-19 PER use, while past-year PER visits correlated with Re-entry PER use.Conclusions and Scientific Significance: During COVID-19, veterans whose main treatment modality was telephone were more likely to require PER services than veterans who were seen by video, even after controlling for age, AUD, opioid use disorder, and past-year PER visits. This study is the first to have examined SUD treatment modality utilization patterns in response to COVID-19. Findings suggest that treatment modality during the initial phase of COVID-19 correlated with PER presentation.

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ED Visits for Schizophrenia Spectrum Disorders During the COVID-19 Pandemic at 5 Campus Health Systems

Singh,

Nawaz,

Seiber

et al. 2023

JAMA Netw Open

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ImportanceAlthough substantial research has reported grave population-level psychiatric sequelae of the COVID-19 pandemic, evidence pertaining to temporal changes in schizophrenia spectrum disorders in the US following the pandemic remains limited.ObjectiveTo examine the monthly patterns of emergency department (ED) visits for schizophrenia spectrum disorders after the onset of the COVID-19 pandemic.Design, Setting, and ParticipantsThis observational cohort study used time-series analyses to examine whether monthly counts of ED visits for schizophrenia spectrum disorders across 5 University of California (UC) campus health systems increased beyond expected levels during the COVID-19 pandemic. Data included ED visits reported by the 5 UC campuses from 2016 to 2021. Participants included persons who accessed UC Health System EDs had a diagnosis of a psychiatric condition. Data analysis was performed from March to June 2023.ExposuresThe exposures were binary indicators of initial (March to May 2020) and extended (March to December 2020) phases of the COVID-19 pandemic.Main Outcomes and MeasuresThe primary outcome was monthly counts of ED visits for schizophrenia spectrum disorders. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes, categorized within Clinical Classification Software groups, were used to identify ED visits for schizophrenia spectrum disorders and all other psychiatric ED visits, from the University of California Health Data Warehouse database, from January 2016 to December 2021. Time-series analyses controlled for autocorrelation, seasonality, and concurrent trends in ED visits for all other psychiatric conditions.ResultsThe study data comprised a total of 377 872 psychiatric ED visits, with 37 815 visits for schizophrenia spectrum disorders. The prepandemic monthly mean (SD) number of ED visits for schizophrenia spectrum disorders was 519.9 (38.1), which increased to 558.4 (47.6) following the onset of the COVID-19 pandemic. Results from time series analyses, controlling for monthly counts of ED visits for all other psychiatric conditions, indicated 70.5 additional ED visits (95% CI, 11.7-129.3 additional visits; P = .02) for schizophrenia spectrum disorders at 1 month and 74.9 additional visits (95% CI, 24.0-126.0 visits; P = .005) at 3 months following the initial phase of the COVID-19 pandemic in California.Conclusions and RelevanceThis study found a 15% increase in ED visits for schizophrenia spectrum disorders within 3 months after the initial phase of the pandemic in California across 5 UC campus health systems, underscoring the importance of social policies related to future emergency preparedness and the need to strengthen mental health care systems.

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Patient Volume and Dispositions in a VA Psychiatric Emergency Room During COVID-19

Cited by 9 publications

References 4 publications

The Analysis of National Health Insurance for Hospital Daily Patient Visits During Covid-19 in Mother-Child Hospital “Putri” Surabaya, Indonesia

The Analysis of National Health Insurance for Hospital Daily Patient Visits During Covid-19 in Mother-Child Hospital “Putri” Surabaya, Indonesia

Treatment utilization and modality preference among veterans receiving outpatient substance use disorder treatment during a pandemic

ED Visits for Schizophrenia Spectrum Disorders During the COVID-19 Pandemic at 5 Campus Health Systems

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