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Demographic Trends in Emergency Department Visits for Psychiatric Concerns During the COVID-19 Pandemic.
James, Jose K; Jeffery, Molly M; Campbell, Ronna L; Wieland, Mark L; Ryu, Alexander J.
  • James JK; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
  • Jeffery MM; Division of Health Care Policy & Research, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
  • Campbell RL; Department of Emergency Medicine, Mayo Clinic, Rochester, MN.
  • Wieland ML; Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
  • Ryu AJ; Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc Innov Qual Outcomes ; 6(5): 436-442, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2031553
ABSTRACT

Objective:

To describe changes in emergency department (ED) psychiatric visits during the pandemic in both rural and nonrural regions in the United States.

Methods:

This cohort study was performed across 22 EDs in the Midwest and Southern United States from January 1, 2019 to April 22, 2021. Prevalence of psychiatric visits before and after the COVID-19 pandemic, defined as starting on March 1, 2020, were compared. Psychiatric and nonpsychiatric visits were defined on the basis of primary clinician-assigned diagnosis. The primary end point was average daily visits normalized to the average daily visit count before the pandemic, labeled as relative mean daily visits (RMDVs).

Results:

Psychiatric visits decreased by 9% [RMDVs, 0.91; 95% confidence interval (CI), 0.89-0.93] during the pandemic period, whereas nonpsychiatric visits decreased by 17% (RMDVs, 0.83; 95% CI, 0.81-0.84). Black patients were the only demographic group with a significant increase in psychiatric visits during the pandemic (RMDVs, 1.12; 95% CI, 1.04-1.19). Periods of outbreaks of psychiatric emergencies were identified in most demographic groups, including among male and pediatric patients. However, the outbreaks detected among Black patients sustained the longest at 6 months. Unlike older adults who experienced outbreaks in the spring and fall of 2020, outbreaks among pediatric patients were detected later in 2021.

Conclusion:

In this multisite study, total ED visits declined during the pandemic; however, psychiatric visits declined less than nonpsychiatric visits. Black patients experienced a greater increase in psychiatric emergencies than other demographic groups. There is also a concern for increasing outbreaks of pediatric psychiatric visits as the pandemic progresses.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Mayo Clin Proc Innov Qual Outcomes Year: 2022 Document Type: Article Affiliation country: J.mayocpiqo.2022.07.003

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Mayo Clin Proc Innov Qual Outcomes Year: 2022 Document Type: Article Affiliation country: J.mayocpiqo.2022.07.003