The Effect of the COVID-19 Pandemic on the Economics of United States Emergency Care.

Annals of Emergency Medicine
Jesse M PinesUS Acute Care Solutions Research Group

Abstract

We describe how the coronavirus disease 2019 (COVID-19) pandemic affected the economics of emergency department care (ED). We conducted an observational study of 136 EDs from January 2019 to September 2020, using 2020-to-2019 3-week moving ratios for ED visits, complexity, revenue, and staffing expenses. We tabulated 2020-to-2019 staffing ratios and calculated hour and full-time-equivalent changes. Following the COVID-19 pandemic's onset, geriatric (age ≥65), adult (age 18 to 64), and pediatric (age <18) ED visits declined by 43%, 40%, and 73%, respectively, compared to 2019 visits and rose thereafter but remained below 2019 levels through September. Relative value units per visit rose by 8%, 9%, and 18%, respectively, compared to 2019, while ED admission rates rose by 32%. Both fell subsequently but remained above 2019 levels through September. Revenues dropped sharply early in the pandemic and rose gradually but remained below 2019 levels. In medium and large EDs, staffing and expenses were lowered with a lag, largely compensating for lower revenue at these sites, and barely at freestanding EDs. Staffing and expense reductions could not match revenue losses in smaller EDs. During the pandemic, emergency physician and advanced...Continue Reading

References

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Jan 7, 2021·The American Journal of Emergency Medicine·Jessica E GalarragaJesse M Pines
Mar 27, 2021·The American Journal of Emergency Medicine·Jesse M PinesUNKNOWN US Acute Care Solutions Research Group

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Citations

Aug 17, 2021·Advanced Emergency Nursing Journal·Dian Dowling EvansJennifer Wilbeck
Sep 11, 2021·International Journal of Emergency Medicine·Dennis G BartenArjen Boin

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