Delayed emergencies in COVID times

COVID-19 changed every aspect of our lives, from shopping for groceries to visiting doctors. Early public health messages encouraged people who thought they could put off emergency care to avoid the emergency department (ED), to save capacity for an anticipated surge of COVID cases. A new study confirms earlier findings from the Centers for Disease Control and Prevention (CDC) showing quite how often this occurred. It also gives us new insights into who stayed home and what kind of care they deferred.

A line graph showing the Percentage change in ED visits by week 1–20 for 2020 versus 2019 and 2019 versus 2018 for adults with non-respiratory diseases.
Percentage change in ED visits by week 1–20 for 2020 versus 2019, and 2019 versus 2018 for adults with non-respiratory diseases. (Image: Friedman et al., Journal of the American College of Emergency Physicians Open, 2021)

We studied EDs in Louisiana, one of the earliest and hardest hit areas of the country. A partnership between the Leonard Davis Institute, led by LDI senior fellow Guy David, Blue Cross and Blue Shield of Louisiana, and Gunnarsson Consulting used claims data to assess patterns across a broad swath of EDs. Not surprisingly, the team found that utilization of EDs declined dramatically in a short period of time. But the magnitude and specific patterns were unexpected.

The researchers found that ED visits for non-respiratory complaints declined by 39% at the beginning of the pandemic.

The findings are consistent with the CDC, which found ED visits declined by 42% from March 29-April 25, 2020, when compared to similar dates in 2019. The CDC data provides a national scope but has some limitations, including a shift in the hospitals included over time.

Within those large overall declines, the study sheds light on who stayed home and what kinds of care they deferred.

This story is by Neil Ray, Ari B. Friedman, and Guy David. Read more at Penn LDI.