Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 6;17(1):e0262347.
doi: 10.1371/journal.pone.0262347. eCollection 2022.

Pandemic-related declines in hospitalization for non-COVID-19-related illness in the United States from January through July 2020

Jennifer L Nguyen  1   2 , Michael Benigno  1 , Deepa Malhotra  1 , Farid Khan  2 , Frederick J Angulo  2 , Jennifer Hammond  3 , David L Swerdlow  2 , Maya Reimbaeva  4 , Birol Emir  5 , John M McLaughlin  2
Affiliations

Pandemic-related declines in hospitalization for non-COVID-19-related illness in the United States from January through July 2020

Jennifer L Nguyen et al. PLoS One. .

Abstract

Background: The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has substantially impacted healthcare utilization worldwide. The objective of this retrospective analysis of a large hospital discharge database was to compare all-cause and cause-specific hospitalizations during the first six months of the pandemic in the United States with the same months in the previous four years.

Methods: Data were collected from all hospitals in the Premier Healthcare Database (PHD) and PHD Special Release reporting hospitalizations from January through July for each year from 2016 through 2020. Hospitalization trends were analyzed stratified by age group, major diagnostic categories (MDCs), and geographic region.

Results: The analysis included 286 hospitals from all 9 US Census divisions. The number of all-cause hospitalizations per month was relatively stable from 2016 through 2019 and then fell by 21% (57,281 fewer hospitalizations) between March and April 2020, particularly in hospitalizations for non-respiratory illnesses. From April onward there was a rise in the number of monthly hospitalizations per month. Hospitalizations per month, nationally and in each Census division, decreased for 20 of 25 MDCs between March and April 2020. There was also a decrease in hospitalizations per month for all age groups between March and April 2020 with the greatest decreases in hospitalizations observed for patients 50-64 and ≥65 years of age.

Conclusions: Rates of hospitalization declined substantially during the first months of the COVID-19 pandemic, suggesting delayed routine, elective, and emergency care in the United States. These lapses in care for illnesses not related to COVID-19 may lead to increases in morbidity and mortality for other conditions. Thus, in the current stage of the pandemic, clinicians and public-health officials should work, not only to prevent SARS-CoV-2 transmission, but also to ensure that care for non-COVID-19 conditions is not delayed.

PubMed Disclaimer

Conflict of interest statement

F.J.A, M.B, B.E, J.H, F.K, D.M, J.M.M, J.L.N, M.R, and D.L.S. are or were employees of Pfizer Inc and may hold stock or stock options. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Hospital selection criteria.
PHD = Premier Healthcare Database.
Fig 2
Fig 2. Average monthly hospitalizations, January-July, 2016–2019 compared to monthly hospitalizations and monthly reported COVID-19 cases* in 2020, United States.
(A) All-cause hospitalizations, (B) Non–respiratory system hospitalizations, (C) Respiratory system and COVID-19 hospitalizations. Dashed blue line, 2016–2019 hospitalizations; dotted green line, 2020 hospitalizations; solid red line (right-side y-axis), COVID-19 cases; solid black line, COVID-19 hospitalizations; vertical black dotted line, when state-mandated social distancing including stay-at-home orders began (mid-March 2020). COVID-19 = coronavirus disease 2019. *COVID-19 case counts were extracted from the COVID-19 Dashboard by the Center for Systems Science and Engineering at Johns Hopkins University [17].
Fig 3
Fig 3. Average monthly hospitalizations, January-July, in 2016–2019 compared with monthly hospitalizations in 2020, by major diagnostic category, United States.
Dashed blue line, 2016–2019 hospitalizations; dotted green line, 2020 hospitalizations; vertical black dotted line, when stay-at-home orders began (mid-March 2020). COVID-19 = coronavirus disease 2019.
Fig 4
Fig 4. Average monthly all-cause hospitalizations, January-July, in 2016–2019 compared with monthly all-cause hospitalizations in 2020, by age group, United States.
Vertical black dotted line, when stay-at-home orders began (mid-March 2020). COVID-19 = coronavirus disease 2019.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Estimated Disease Burden of COVID-19 2021 [updated January 19; cited 2021 February 22]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html.
    1. Prevention CfDCa. CDC COVID Data Tracker 2021. [updated January 12 2021; cited 2021 January 12]. Available from: https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases.
    1. Federal Government of the United States of America. Declaring a national emergency concerning the novel coronavirus disease (COVID–19) outbreak. 2020 March 18. Report No.
    1. Cowling BJ, Aiello AE. Public health measures to slow community spread of coronavirus disease 2019. J Infect Dis. 2020; 221(11): 1749–51. doi: 10.1093/infdis/jiaa123 - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. Framework for healthcare systems providing non-COVID-19 clinical care during the COVID-19 pandemic 2020 [updated June 30; cited 2020 December 2]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/framework-non-COVID-care.html.

Publication types

MeSH terms