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. 2021 Sep:47:187-191.
doi: 10.1016/j.ajem.2021.04.019. Epub 2021 Apr 20.

The impact of the COVID-19 pandemic on the utilization of emergency department services for the treatment of injuries

Katherine J Harmon  1 , Mike Dolan Fliss  2 , Stephen W Marshall  3 , Kathy Peticolas  4 , Scott K Proescholdbell  5 , Anna E Waller  6
Affiliations

The impact of the COVID-19 pandemic on the utilization of emergency department services for the treatment of injuries

Katherine J Harmon et al. Am J Emerg Med. 2021 Sep.

Abstract

Context: The global COVID-19 pandemic has had a major impact on the utilization of healthcare services; however, the impact on population-level emergency department (ED) utilization patterns for the treatment of acute injuries has not been fully characterized.

Objective: This study examined the frequency of North Carolina (NC) EDs visits for selected injury mechanisms during the first eleven months of the COVID-19 pandemic.

Methods: Data were obtained from the NC Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), NC's legislatively mandated statewide syndromic surveillance system for the years 2019 and 2020. Frequencies of January - November 2020 NC ED visits were compared to frequencies of 2019 visits for selected injury mechanisms, classified according to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) injury diagnosis and mechanism codes.

Results: In 2020, the total number of injury-related visits declined by 19.5% (N = 651,158) as compared to 2019 (N = 809,095). Visits related to motor vehicle traffic crashes declined by a greater percentage (29%) and falls (19%) declined by a comparable percentage to total injury-related visits. Visits related to assault (15%) and self-harm (10%) declined by smaller percentages. Medication/drug overdose visits increased (10%), the only injury mechanism studied to increase during this period.

Conclusion: Both ED avoidance and decreased exposures may have contributed to these declines, creating implications for injury morbidity and mortality. Injury outcomes exacerbated by the pandemic should be addressed by timely public health responses.

Keywords: COVID-19; Emergency medicine; Injury; Sentinel surveillance.

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Figures

Fig. 1
Fig. 1
Total number of weekly North Carolina emergency department (ED) visits vs. COVID-Like Illness ED visits, with key dates related to the spread and control of COVID-19 in the United States and North Carolina: January to mid-November 2019 & 2020. CLI visits are visually inflated by a factor of 10 on second axis for ease of interpretation. Abbreviations: US = United States; NC = North Carolina; ED = emergency department; CLI = COVID-Like Illness; Jan = January; Feb = February; Mar = March; Apr = April; Jun = June; Jul = July; Aug = August; Sep = September; Oct = October; Nov = November; Dec = December.
Fig. 2
Fig. 2
Weekly North Carolina emergency department visits for selected leading causes of intentional and unintentional injuries: counts and LOESS smooth lines, January–November 2019 & 2020. Abbreviations: ED, emergency department; Jan = January; Feb = February; Mar = March; Apr = April; Jun = June; Jul = July; Aug = August; Sep = September; Oct = October; Nov = November; Dec = December.
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