Changes in Acute ED Visits by Race/Ethnicity During the Early COVID-19 Pandemic

Abstract

Emergency department (ED) visits for conditions unrelated to the Coronavirus Disease 2019 (COVID-19) pandemic decreased during the early pandemic, raising concerns about critically ill patients forgoing care and increasing their risk of adverse outcomes. It is unclear if Hispanic and Black adults, who have a high prevalence of chronic conditions, sought medical assistance for acute emergencies during this time. This study used 2018-2020 ED visit data from the largest safety net hospital in Los Angeles County to estimate ED visit differences for cardiac emergencies, diabetic complications, and strokes, during the first societal lockdown among Black and Hispanic patients using time series analyses. Emergency department visits were lower than the expected levels during the first societal lockdown. However, after the lockdown ended, Black patients experienced a rebound in ED visits while visits for Hispanics remained depressed. Future research could identify barriers Hispanics experienced that contributed to prolonged ED avoidance.

Keywords: Acute medical emergencies; Coronavirus pandemic; Ethnic minorities; Safety net hospital.

Fig. 1

Weekly ED visit counts for acute medical emergencies among Hispanic patients at LAC+USC Medical Center during January 5, 2018, to December 31, 2020. The thick lines indicate the period between March 13 and July 2, 2020. The acute medical emergencies include cardiac emergencies, diabetic complications, and strokes

Fig. 2

Weekly ED visit counts for acute medical emergencies among Black patients at LAC+USC Medical Center during January 5, 2018, to December 31, 2020. The thick lines indicate the period between March 13 and July 2, 2020. The acute medical emergencies include cardiac emergencies, diabetic complications, and strokes