Analysis of Emergency Department Patient-Visit Volumes in an Academic Health System During a COVID-19 Pandemic Statewide 'Safer at Home' Order.

BACKGROUND: We describe patient-visit volumes, patient acuity, and demographics in our 4 academic health system emergency departments (ED) before, during, and after implementation of a COVID-19 pandemic safer-at-home order. METHODS: Data were collected from the electronic health record, including patient-visit volumes, chief complaint, Emergency Severity Index (ESI), and patient demographics. Descriptive statistics were performed. RESULTS: There was a 37% decrease in combined ED patient-visit volume during the safer-at-home order period (42% at the academic medical center). ED patient-visit volumes increased after the safer-at-home order concluded. During the safer-at-home order period, there was an increase in the proportion of ESI-2 visits and admission rates from EDs across the system. CONCLUSIONS: Significant differences in ED patient-visit volumes and patient acuity were associated with a safer-at-home order in our academic health system. These differences are similar to experiences of other hospital systems across the country.

Short-term impact of COVID-19 on quality of life, perceived stress, and serious psychological distress in an adult population in the midwest United States.

PURPOSE: This study aimed to investigate changes over time in quality of life, perceived stress, and serious psychological distress for individuals diagnosed with COVID-19 in an urban academic health system. METHODS: Phone-based surveys were completed with adult patients tested for COVID-19 during emergency department visits, hospitalizations, or outpatient visits at the Froedtert and Medical College of Wisconsin Health Network. Data were then matched to medical record data. Unadjusted and adjusted mixed effects linear models using random intercept were run for each outcome (physical health-related quality of life, mental health-related quality of life, perceived stress, and serious psychological distress) with time (baseline vs 3-month follow-up) as the primary independent variable. Individuals were treated as a random effect, with all covariates (age, sex, race/ethnicity, payor, comorbidity count, hospitalization, and intensive care unit (ICU) stay) treated as fixed effects. RESULTS: 264 adults tested positive for COVID-19 and completed baseline and 3-month follow-up assessments. Of that number, 31.8% were hospitalized due to COVID-19, and 10.2% were admitted for any reason to the ICU. After adjustment, patients reported higher physical health-related quality of life at 3 months compared to baseline (0.63, 95% CI 0.15, 1.11) and decreased stress at 3 months compared to baseline (- 0.85, 95% CI - 1.33, - 0.37). There were no associations between survey time and mental health-related quality of life or serious psychological distress. CONCLUSIONS: Results suggest the influence of COVID-19 on physical health-related quality of life and stress may resolve over time, however, the influence of mental health on daily activities, work, and social activities may not.