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. 2022 Jan 20;3(1):e12622.
doi: 10.1002/emp2.12622. eCollection 2022 Feb.

COVID-19 hospital and emergency department visitor policies in the United States: Impact on persons with cognitive or physical impairment or receiving end-of-life care

Alexander X Lo  1   2 , Logan K Wedel  1 , Shan W Liu  3   4 , Thiti Wongtangman  3   5 , Phraewa Thatphet  3   6 , Ilianna Santangelo  3 , Anita N Chary  7 , Paul D Biddinger  3   4   8 , Corita R Grudzen  9 , Maura Kennedy  3   4
Affiliations

COVID-19 hospital and emergency department visitor policies in the United States: Impact on persons with cognitive or physical impairment or receiving end-of-life care

Alexander X Lo et al. J Am Coll Emerg Physicians Open. .

Abstract

Objective: To characterize the national distribution of COVID-19 hospital and emergency department visitor restriction policies across the United States, focusing on patients with cognitive or physical impairment or receiving end-of-life care.

Methods: Cross-sectional study of visitor policies and exceptions, using a nationally representative random sample of EDs and hospitals during the first wave of the COVID-19 pandemic, by trained study investigators using standardized instrument.

Results: Of the 352 hospitals studied, 326 (93%) had a COVID-19 hospital-wide visitor restriction policy and 164 (47%) also had an ED-specific policy. Hospital-wide policies were more prevalent at academic than non-academic (96% vs 90%; P < 0.05) and at urban than rural sites (95% vs 84%; P < 0.001); however, the prevalence of ED-specific policies did not significantly differ across these site characteristics. Geographic region was not associated with the prevalence of any visitor policies. Among all study sites, only 58% of hospitals reported exceptions for patients receiving end-of-life care, 39% for persons with cognitive impairment, and 33% for persons with physical impairment, and only 12% provided policies in non-English languages. Sites with ED-specific policies reported even fewer exceptions for patients with cognitive impairment (29%), with physical impairments (24%), or receiving end-of-life care (26%).

Conclusion: Although the benefits of visitor policies towards curbing COVID-19 transmission had not been firmly established, such policies were widespread among US hospitals. Exceptions that permitted family or other caregivers for patients with cognitive or physical impairments or receiving end-of-life care were predominantly lacking, as were policies in non-English languages.

Keywords: COVID‐19; dementia; disability; end‐of‐life; health disparities; older adults; visitor policy.

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Conflict of interest statement

The authors have no conflicts of interest to report.

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