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. 2021 Jun 1;16(6):e0252441.
doi: 10.1371/journal.pone.0252441. eCollection 2021.

The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

Elissa Rennert-May  1   2   3   4   5 , Jenine Leal  1   2   4   6 , Nguyen Xuan Thanh  7 , Eddy Lang  8 , Shawn Dowling  8 , Braden Manns  1   3   4   9 , Tracy Wasylak  7 , Paul E Ronksley  1   4
Affiliations

The impact of COVID-19 on hospital admissions and emergency department visits: A population-based study

Elissa Rennert-May et al. PLoS One. .

Abstract

Background: As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020.

Methods: We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC).

Findings: There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol.

Conclusions: Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Number of medical hospital admissions via the emergency department per day.
Fig 2
Fig 2. Number of surgical hospital admissions via the emergency department per day.
Fig 3
Fig 3. Number of emergency department visits per day for any reason.
Fig 4
Fig 4. Number of emergency department visits per day for ambulatory care sensitive conditions.
See this image and copyright information in PMC

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