BRYAN, TEXAS — When we think of places particularly hit hard by the COVID-19 pandemic, we think of emergency departments at the rescue to so many.
Researchers in Aggieland and beyond concluded Emergency Department visits actually declined from mid-March to August 2020.
In the study titled "Trends in outpatient emergency department visits during the COVID-19 pandemic at a large, urban, academic hospital system" researchers aimed to analyze trends in the number of outpatient ED visits during the COVID-19 pandemic.
As published in the American Journal of Emergency Medicine, the study used data from a large urban academic hospital system in Utah and data from treat-and-release emergency department visits during the pandemic.
"In this paper, we wanted to evaluate whether there are changes in the emergency department use during the COVID-19 times specifically in April of 2020, when the majority of the stay at home orders kicked in and people were really discouraged from going anywhere," Dr. Elena Andreyeva, Assistant Professor in the Department of Health Policy and Management with A&M's School of Public Health shared with KRHD 25 News.
Dr. Andreyeva says they found from Jan 2020-Aug 2020, the Emergency Department use was lower than the similar time frame in 2019, one year before COVID-19.
"Specifically, we saw a huge drop in the ED use in April, as expected, because this was the month where Stay-at-home orders were the strictest and what we found is that ED use decreased for individuals with these non-emergent conditions that can be treated elsewhere," she added.
Her former student, Dr. Theodoros Giannouchos explains a few changes during that time.
"Now we have confusion and fear and anxiety about where to seek care, we have closure of so many community clinics. We thought it would be interesting to compare the pre-pandemic to during or post-pandemic to see what happened," Dr. Giannouchos, a recent doctoral graduate within the School of Public Health said.
Dr. Giannouchos says EDs serve patients with the most emergent needs. "We know from the literature that they commonly serve patients with non-urgent conditions. ED is open 24/7. There is a convenience in operating hours and patients can get timely access exactly when they want," Dr. Giannouchos said.
Dr. Giannouchos is now with the University of Utah College of Pharmacy, but received his Ph.D. in Health Services Research with Texas A&M's School of Public Health in 2020.
He says in the U.S. around 40% of all ED visits are non-emergent, which he says is alarming.
In the findings, one of the biggest declines in visits to the ED were classified as non-emergent, of which conditions could be treated elsewhere like urgent care and primary care offices.
Dr. Andreyeva says EDs are some of the most expensive care settings in the US, even if you have insurance, it is still expensive for someone to get care at an ED, versus with a PCP or at urgent care.
"More awareness should be raised for individuals about other more appropriate avenues for getting care, if the condition is not emergent. Obviously, if it's a heart attack go to the Emergency Department," Dr. Andreyeva added.
Dr. Andreyeva said another reason people may be using ED so much is because they may not have another avenue for obtaining care.
"if you are an uninsured individual, the only way for you really to get healthcare is to go to an ED because you can't be turned away when you can be turned away from a physician's office or an urgent care clinic. I think these give us a huge opportunity to see that some people do utilize an ED for conditions that could be treated elsewhere," Dr. Andreyeva added.
Dr. Giannouchos also says in the study some visits shouldn't have declined, but they did. "that's probably related to fear and anxiety. Healthcare centers were deemed as COVID-hubs. People were scared," he added.
One hospital group in the Brazos Valley says they saw a dramatic decrease in those wishing to seek care from their ED during the height of COVID-19, but things are slowly picking back up.
"It lasted for several months....when talking with patients one-on-one they basically said they were scared. Scared to come in. They didn't want to be exposed. Not only did they not want to go out to a restaurant, but they didn't want to go to the ED where all the sick people definitely were going to be," Dr. Paul Goen MD and System Medical Director with St. Joseph Emergency Medicine said.
The decline, Dr. Goen says, left some in risky health positions.
"It was sad because we would see cases of people who that would be three days out from their stroke and there was nothing we could do or three days out from their heart attack and the damage was done. Now with the immunizations and things opening up, we are starting to see a swing back and we are starting to get back to our pre-COVID visitation levels," Dr. Goen added.
Outside of fear of contracting the virus, another reason for the decline in ED visits was because people were successfully using TeleHealth, Dr. Andreyva said. "TeleHealth can help. It should be here to stay. It should be used more widely, and awareness of TeleHealth should be raised among potential patients."
Dr. Giannouchos says this evidence-based study can be used to help redesign healthcare in the United States which can improve population health.
In an Article from Texas A&M Health, "recent doctoral graduate from the Texas A&M University School of Public Health Theodoros Giannouchos, PhD, along with Benjamin Ukert, PhD, and Elena Andreyeva, PhD, assistant professors in the Department of Health Policy and Management at the School of Public Health, as well as colleagues from the University of Utah, analyzed data on outpatient ED visits at a hospital in Salt Lake City, Utah."
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