The Impact of COVID-19 on Patient Presentations to the Emergency Department.

Introduction As the coronavirus disease 2019 (COVID-19) pandemic continues, it may be useful to elucidate its impact on services in the emergency department (ED). This research project aims to identify and analyze changes in patient presentations and disease severity within the ED at Hurley Medical Center (HMC) in Flint, Michigan, due to the COVID-19 pandemic. Methods The study is a retrospective chart review focusing on adults 18 years and above who presented to HMC's ED. The data collected for the study was obtained from patient charts from February 1, 2019, to July 31, 2019, and from February 1, 2020, to July 31, 2020. Data from the years 2019 and 2020 were analyzed using a combination of independent t-test, chi-square analysis, and regression modeling. Results There were a total of 59,345 visits analyzed within the study; 33,648 ED visits within the study were in 2019 compared to 25,697 visits in 2020. There was a significant difference in patient sex between 2019 and 2020 with a larger percentage of males presenting in 2020 versus 2019 (p<0.001). Dispositions also significantly differed in 2020 compared to 2019 with more patients being admitted or dying in the ED (p<0.001). Patients who presented to the ED often presented with more severe illness in 2020 as reflected in increased length of stay in 2020 (p=0.01) and increased case mix index (p<0.001). Conclusion The COVID-19 pandemic significantly reduced the total number of ED visits to HMC in Flint, Michigan, in 2020 than in 2019. Notably, patients were more likely to have a longer length of stay, present with more severe illness, and be admitted or die in the ED when compared to 2019. The results from this study can be used for future planning for the next public health emergency.