Abstract
IntroductionDuring the coronavirus disease 2019 (COVID-19) pandemic, a reduction in emergency department (ED) visits was seen nationally according to the US Centers for Disease Control and Prevention. However, no data currently exists for the impact of ED transfers to a higher level of care during this same time period. The primary objective of the study was to determine whether the COVID-19 pandemic affected the rate of non-COVID-19 transfers from a rural community ED.MethodsWe completed a retrospective chart review of all ED patients who presented to Kingman Regional Medical Center in Kingman, Arizona, from March 1–June 31, 2019 and March 1–June 31, 2020. To ensure changes were not due to seasonal trends, we examined transfer rates from the same four-month period in 2019 and 2020. Patients were included in the study if they were transferred to an outside facility for a higher level of care not related to COVID-19.ResultsBetween the time periods studied there was a 25.33% (P = 0.001) reduction in total ED volume and a 21.44% (P = 0.009) reduction in ED transfers to a higher level of care. No statistical difference was noted in ED transfer volume following adjustment for decreased ED volumes. Transfers for gastroenterology (45%; P = 0.021), neurosurgery (29.2%; P = 0.029), neurology (76.3%; P < 0.001), trauma (37.5%; P = 0.039), urology (41.8%; P = 0.012), and surgery (56.3%; P = 0.028) all experienced a decrease in transfer rates during the time period studied. When gender was considered, males exhibited an increased rate of transfers to psychiatric facilities (P = 0.018).ConclusionSignificant reductions in both ED volume and transfers have coincided with the emergence of the COVID-19 pandemic. Further research is needed to determine how the current pandemic has affected patient care.
Highlights
During the coronavirus disease 2019 (COVID-19) pandemic, a reduction in emergency department (ED) visits was seen nationally according to the US Centers for Disease Control and Prevention
To ensure changes were not due to seasonal trends, we examined transfer rates from the same four-month period in 2019 and 2020
Patients were included in the study if they were transferred to an outside facility for a higher level of care not related to COVID-19
Summary
As cases of the novel coronavirus disease 2019 (COVID-19) increased across the globe, a sharp decrease in emergency department (ED) volumes was noted for various chief complaints while an increase was seen in out-of-hospital cardiac arrests.[1,2,3,4,5] As cases of COVID-19 began to climb in the United States, a 42% reduction in ED volume was reported. Impact of the COVID-19 on ED Transfers by the National Syndromic Surveillance Program between March 29–April 25, 2020.6 The steepest decrease was noted in females, pediatric patients, and those who lived in the Northeast.[6] data is lacking for those patients who were transferred to a higher level of care after ED evaluation during the current pandemic. In this study we sought to determine whether the rates of non-COVID-19 transfers from a rural ED varied alongside the 2020 COVID-19 pandemic
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