The following is a summary of “Emergency Department Volume, Severity, and Crowding Since the Onset of the Coronavirus Disease 2019 Pandemic,” published in the December 2023  issue of Emergency Medicine by Oskvarek et al.

For a study, researchers sought to determine the number of visits to the emergency room (ED), the seriousness of the sickness, and the number of people crowded from the start of the coronavirus disease 2019 (COVID-19) outbreak until mid-2022. They compared monthly data from 14 million visits to 111 EDs in 18 states run by a national ED practice group from March 2020 to August 2022 with the same months in 2019 to see how many people went to the ED, how bad their sickness was, and how crowded it was. Average monthly ED numbers dropped in the early stages of the pandemic. 

They partly recovered in 2022 but were still lower than in 2019 (915 patients per ED in 2019 to 826.6 in 2022 for admitted patients; 3,026.9 to 2,478.5 for released patients). The percentage of visits considered urgent care rose from 7.9% in 2019 to 11.0% in 2022, but the number of visits went down from 318,802 to 264,350. The percentage of visits that were billed as 99285 (the most serious Evaluation and Management code for noncritical care visits) rose from 35.4% in 2019 to 40.0% in 2022, but the total number of visits went down from 1,434,454 to 952,422.  

The average length of stay for admitted patients increased by 32% (5.2 to 6.9 hours) and 47% (11.7 to 17.4 hours) in 2022 compared to 2019. The number of patients who left treatment early rose by 86%, from 2.9% to 5.4%. The 90th percentile length of stay for people with a mental health condition who were admitted went from 20 hours to more than one day. Early in the pandemic, fewer people went to the emergency room, and that number has only partly returned. ED traffic has gotten worse even though output has gone down. Psychiatric people have a bigger problem with this.

Source: sciencedirect.com/science/article/abs/pii/S019606442300598X