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Changes in Emergency Department Volumes at the Largest U.S. Military Hospital During the COVID-19 Pandemic
Adrianna Long1,2, Meghan Fillinger1, Michael D April3
1Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA.
Insights
The COVID-19 pandemic significantly reduced patient visits to the Brooke Army Medical Center emergency department. This decrease impacts the hospital's ability to maintain a medically ready force.
Area of Science:
- Emergency Medicine
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic profoundly altered global healthcare delivery systems.
- Brooke Army Medical Center (BAMC) is a key military medical facility crucial for maintaining force readiness.
Purpose of the Study:
- To compare patient volumes and characteristics in the BAMC Emergency Department (ED) before and during the COVID-19 pandemic.
- To assess the impact of the pandemic on healthcare delivery at a major military medical center.
Main Methods:
- Retrospective analysis of electronic medical record data from the BAMC ED.
- Comparison of patient demographics, visit dates, triage levels, and dispositions between pre-pandemic (March-November 2019) and pandemic (March-November 2020) periods.
Main Results:
- A significant decrease in daily median patient visits was observed during the pandemic period (165 visits) compared to the pre-pandemic period (232 visits).
- Pediatric patient visits also saw a substantial reduction, with median daily visits dropping from 39 to 18.
- Monthly patient volumes were consistently lower during the pandemic across all observed months.
Conclusions:
- The BAMC ED experienced a significant decline in patient volume following the onset of the COVID-19 pandemic in March 2020.
- This reduction in patient flow may have critical implications for BAMC's capacity to sustain medical readiness for military personnel.
Introduction:
The coronavirus-2019 (COVID-19) pandemic has significantly impacted global healthcare delivery. Brooke Army Medical Center (BAMC) is the DoD's largest hospital and a critical platform for maintaining a ready medical force. We compare temporal trends in patient volumes and characteristics in the BAMC emergency department (ED) before versus during the pandemic.
Materials And Methods:
We abstracted data on patient visits from the BAMC ED electronic medical record system. Data included patient demographics, visit dates, emergency severity index triage level, and disposition. We visually compared the data from January 1, 2019 to November 30, 2019 versus January 1, 2020 to November 30, 2020 to assess the period with the most apparent differences. We then used descriptive statistics to characterize the pre-pandemic control period (1 March-November 30, 2019) versus the pandemic period (1 March-November 30, 2020).
Results:
Overall, when comparing the pre-pandemic and pandemic periods, the median number of visits per day was 232 (Interquartile Range (IQR) 214-250, range 145-293) versus 165 (144-193, range 89-308, P < .0001). Specific to pediatric visits, we found the median number of visits per day was 39 (IQR 33-46, range 15-72) versus 18 (IQR 14-22, range 5-61, P < .001). When comparing the median number of visits by month, the volumes were lower during the pandemic for all months, all of which were strongly significant (P < .001 for all).
Conclusions:
The BAMC ED experienced a significant decrease in patient volume during the COVID-19 pandemic starting in March 2020. This may have significant implications for the capacity of this facility to maintain a medically ready force.
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