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Volume and Acuity of Emergency Department Visits Prior To and After COVID-19
Adeel A Butt1, Aftab M Azad1, Anand B Kartha1
1Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medical College, Doha Qatar and New York, New York.
Insights
Emergency department visits and patient acuity significantly decreased during the COVID-19 pandemic. This decline in emergency department (ED) volumes and triage acuity raises concerns about delayed care for critically ill patients.
Area of Science:
- Emergency Medicine
- Public Health
- Infectious Diseases
Background:
- Limited data exist on emergency department (ED) patient volumes and acuity post-Coronavirus Disease 2019 (COVID-19).
- Understanding these changes is crucial for assessing healthcare system impact during the pandemic.
Purpose of the Study:
- To quantify changes in ED patient volumes and triage acuity before and after the onset of COVID-19.
- To compare pre-pandemic (2019, January 2020) and pandemic (March-April 2020) ED data.
Main Methods:
- Analysis of 192,157 ED visits across four major hospitals in Qatar (general, cardiac, cancer, obstetrics).
- Comparison of patient volumes and Canadian Triage Acuity Scale (CTAS) levels between 2019, January 2020, and March-April 2020.
- The first COVID-19 case in Qatar was reported on February 29, 2020.
Main Results:
- A 20-43% overall decrease in ED visits was observed, with significant variation across hospitals.
- The Heart Hospital saw the largest decline (33-89%), while the National Center for Cancer Care and Research experienced the least.
- Declines were noted across all CTAS levels, with the most significant drops in CTAS 1 and 2 patients (26-69% decrease).
- National statistics indicated no increase in overall deaths or crude mortality rates during the COVID-19 era.
Conclusions:
- Significant reductions in ED visits and triage acuity suggest that severely ill patients may be delaying or avoiding care.
- A potential surge in critically ill patients presenting to EDs may occur after movement restrictions are eased.
- Healthcare systems must prepare for potential future surges and ensure timely access to emergency care.
Background:
There are scant data regarding the change in volume and acuity of patients presenting to emergency departments (EDs) after Coronavirus Disease 2019 (COVID-19), compared with the pre-COVID-19 era.
Objective:
To determine ED volumes and triage acuity prior to and after COVID-19.
Methods:
We determined the volume of patients presenting to four large EDs affiliated with general, cardiac, cancer, and obstetrics hospitals, and the acuity of presenting illness (using the Canadian Triage Acuity Scale [CTAS]) for March and April 2020 and compared them with the same months in 2019 and January 2020. Together, these facilities see over 80% of the ED visits in Qatar. The first COVID-19 patient in Qatar was diagnosed on February 29, 2020.
Results:
A total of 192,157 ED visits were recorded during the study period. There was a 20-43% overall drop in number of ED visits, with significant variability across hospitals. The Heart Hospital experienced the sharpest decline (33-89%), and the National Center for Cancer Care and Research experienced the least decline in volumes. The decline was observed across all CTAS levels, with the largest decline observed in individuals presenting with CTAS 1 and 2 (26-69% decline month by month). No increase in overall number of deaths or crude mortality rate was observed in the COVID-19 era, according to national statistics.
Conclusions:
Sharp declines in ED visits and the triage acuity seen in both general and specialty hospitals raise the concern that severely ill patients may not be seeking timely care, and a surge may be expected once current restrictions on movement are lifted.
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