Evidence map›Paper›PMID 33892402›Full record

ArticleThe American journal of emergency medicine2021

The impact of the COVID-19 pandemic and governor mandated stay at home order on emergency department super utilizers.

Shannon Alwood, Mandi W Musso, Glenn N Jones, Joel Mosley, Brittany Wippel, Lauren Theriot, Diana Hamer

Abstract read
In one paragraph

Article in The American journal of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Shannon AlwoodLouisiana State University Health Sciences Center Emergency Medicine Residency Program, 5246 Brittany Dr., Baton Rouge, LA 70808, United States of America. Electronic address: salwoo@lsuhsc.edu.
Mandi W MussoLouisiana State University Health Sciences Center Emergency Medicine Residency Program, 5246 Brittany Dr., Baton Rouge, LA 70808, United States of America; Our Lady of the Lake Regional Medical Center, 5000 Hennessey Blvd., Baton Rouge, LA 70808, United States of America.
Glenn N JonesLouisiana State University Health Sciences Center, Family Medicine, 5246 Brittany Dr., Baton Rouge, LA 70808, United States of America.
Joel MosleyLouisiana State University Health Sciences Center Emergency Medicine Residency Program, 5246 Brittany Dr., Baton Rouge, LA 70808, United States of America.
Brittany WippelLouisiana State University Health Sciences Center Emergency Medicine Residency Program, 5246 Brittany Dr., Baton Rouge, LA 70808, United States of America.
Lauren TheriotLouisiana State University Health Sciences Center Emergency Medicine Residency Program, 5246 Brittany Dr., Baton Rouge, LA 70808, United States of America.
Diana HamerOur Lady of the Lake Regional Medical Center, 5000 Hennessey Blvd., Baton Rouge, LA 70808, United States of America; Louisiana State University Health Sciences Center, Internal Medicine Residency Program, 5246 Brittany Dr., Baton Rouge, LA 70808, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the trend of rising Emergency Department (ED) visits over the past decade, researchers have observed drastic declines in number of ED visits due to the COVID-19 pandemic. The purpose of the current study was to examine the impact of the COVID-19 pandemic and governor mandated Stay at Home Order on ED super utilizers.

methodsThis was a retrospective chart review of patients presenting to the 12 emergency departments of the Franciscan Mission of Our Lady Hospital System in Louisiana between January 1, 2018 and December 31, 2020. Patients who were 18 years of age or older and had four ED visits within a one-year period (2018, 2019, or 2020) were classified as super-utilizers. We examined number and category of visits for the baseline period (January 2018 - March 2020), the governor's Stay at Home Order, and the subsequent Reopening Phases through December 31, 2020.

resultsThe number of visits by super utilizers decreased by over 16% when the Stay at Home Order was issued. The average number of visits per week rose from 1010.63 during the Stay at Home Order to 1198.09 after the Stay at Home Order was lifted, but they did not return to Pre-COVID levels of approximately 1400 visits per week in 2018 and 2019. When categories of visits were examined, this trend was found for emergent visits (p < 0.001) and visits related to injuries (p < 0.001). Non-emergent visits declined during the Stay at Home Order compared to the baseline period (p < 0.001), and did not increase significantly during reopening compared to the Stay at Home Order (p = 0.87). There were no changes in number of visits for psychiatric purposes, alcohol use, or drug use during the pandemic.

conclusionsSignificant declines in emergent visits raise concerns that individuals who needed ED treatment did not seek it due to COVID-19. However, the finding that super utilizers with non-emergent visits continued to visit the ED less after the Stay at Home Order was lifted raises questions for future research that may inform policy and interventions for inappropriate ED use.

Indexed as

Health PolicyAdolescentAdultAgedAged, 80 and overCOVID-19Emergency Service, HospitalFacilities and Services UtilizationFemaleGovernment RegulationHealth Services AccessibilityHumansLouisianaMaleMedical OveruseMiddle AgedCOVID-19Emergency departmentEmergency department utilizationHigh utilizerSuper utilizer

Identifiers

PMID33892402
PMCPMC8056853

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.