Presentation Title

Comparing the Severity of COVID-19’s Impact on Emergency Departments using ER Chief Complaints and ICD-10 Codes During Admission

Location

Online - Session 5A

Start Date

4-21-2021 3:30 PM

Major Field of Study

Global Public Health

Student Type

Undergraduate

Faculty Mentor(s)

Michaela George, Phd and Brett Bayles, Phd

Presentation Format

Oral Presentation

Abstract/Description

Comparing the Severity of COVID-19’s Impact on Emergency Departments using ED Chief Complaints and ICD-10 Codes During Admission

Natalie Oropeza1, Haylea Hannah2,3, Rochelle Ereman1,3, Brett R. Bayles1, Michaela F. George1

Affiliations: 1. Department of Global Public Health, Dominican University of California, San Rafael, CA, USA 2. Department of Epidemiology and Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA 3. Marin County Department of Health and Human Services, San Rafael, CA, USA

Background: After the shelter in place (SIP) order was issued to mitigate COVID-19 transmission, there was a significant decrease in Emergency Department (ED) visits in Marin County, California. A proportion of this decrease was among patients who typically would have been admitted to the hospital, suggesting substantial deferment of care. However, there is a lack of understanding about the severity of ED admissions during SIP. This analysis describes the severity of ED admissions impacted by SIP in comparison to previous years.

Methods: De-identified and dichotomized data from all three Marin County EDs were analyzed. Severity was defined by the chief complaint field using an algorithm developed by the researchers. A level 1 severity was defined as less severe and a level 5 was defined as more severe. Additionally, using chief complaint and ICD-10 diagnostic codes, hospital admission data will be categorized into severe illness categories. Main outcomes will be stratified using demographic data variables to further describe differences found.

Results: We conducted a descriptive time series analysis of all ED admissions for 2020 (post SIP) as compared to the three previous years 2017, 2018, and 2019 (pre COVID-19) to assess the impacts of the first SIP issued in the US. These results will show the importance of ED utilization for severe illness and emergency treatment during an unprecedented pandemic. Additionally, the data will illuminate which categories of severe illnesses were most impacted by the SIP to inform pandemic preparedness planning and outreach.

Conclusion: This is an important investigation to guide ongoing care in EDs across the country. These results can be used to inform specialty practices and primary care physicians on how best to advise patients' usage of local EDs for severe illness during the COVID-19 pandemic and in the future.

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Apr 21st, 3:30 PM

Comparing the Severity of COVID-19’s Impact on Emergency Departments using ER Chief Complaints and ICD-10 Codes During Admission

Online - Session 5A

Comparing the Severity of COVID-19’s Impact on Emergency Departments using ED Chief Complaints and ICD-10 Codes During Admission

Natalie Oropeza1, Haylea Hannah2,3, Rochelle Ereman1,3, Brett R. Bayles1, Michaela F. George1

Affiliations: 1. Department of Global Public Health, Dominican University of California, San Rafael, CA, USA 2. Department of Epidemiology and Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA 3. Marin County Department of Health and Human Services, San Rafael, CA, USA

Background: After the shelter in place (SIP) order was issued to mitigate COVID-19 transmission, there was a significant decrease in Emergency Department (ED) visits in Marin County, California. A proportion of this decrease was among patients who typically would have been admitted to the hospital, suggesting substantial deferment of care. However, there is a lack of understanding about the severity of ED admissions during SIP. This analysis describes the severity of ED admissions impacted by SIP in comparison to previous years.

Methods: De-identified and dichotomized data from all three Marin County EDs were analyzed. Severity was defined by the chief complaint field using an algorithm developed by the researchers. A level 1 severity was defined as less severe and a level 5 was defined as more severe. Additionally, using chief complaint and ICD-10 diagnostic codes, hospital admission data will be categorized into severe illness categories. Main outcomes will be stratified using demographic data variables to further describe differences found.

Results: We conducted a descriptive time series analysis of all ED admissions for 2020 (post SIP) as compared to the three previous years 2017, 2018, and 2019 (pre COVID-19) to assess the impacts of the first SIP issued in the US. These results will show the importance of ED utilization for severe illness and emergency treatment during an unprecedented pandemic. Additionally, the data will illuminate which categories of severe illnesses were most impacted by the SIP to inform pandemic preparedness planning and outreach.

Conclusion: This is an important investigation to guide ongoing care in EDs across the country. These results can be used to inform specialty practices and primary care physicians on how best to advise patients' usage of local EDs for severe illness during the COVID-19 pandemic and in the future.