{"pk":14756,"title":"Impact of the COVID-19 Pandemic on Emergency Department Transfers to a Higher Level of Care","subtitle":null,"abstract":"Introduction: \nDuring the coronavirus disease 2019 (COVID-19) pandemic, a reduction in emergency department (ED) visits was seen nationally according to the US Centers for Disease Control and Prevention. However, no data currently exists for the impact of ED transfers to a higher level of care during this same time period. The primary objective of the study was to determine whether the COVID-19 pandemic affected the rate of non-COVID-19 transfers from a rural community ED.\nMethods:\n We completed a retrospective chart review of all ED patients who presented to Kingman Regional Medical Center in Kingman, Arizona, from March 1–June 31, 2019 and March 1–June 31, 2020. To ensure changes were not due to seasonal trends, we examined transfer rates from the same four-month period in 2019 and 2020. Patients were included in the study if they were transferred to an outside facility for a higher level of care not related to COVID-19.\nResults:\n Between the time periods studied there was a 25.33% (P = 0.001) reduction in total ED volume and a 21.44% (P = 0.009) reduction in ED transfers to a higher level of care. No statistical difference was noted in ED transfer volume following adjustment for decreased ED volumes. Transfers for gastroenterology (45%; P = 0.021), neurosurgery (29.2%; P = 0.029), neurology (76.3%; P < 0.001), trauma (37.5%; P = 0.039), urology (41.8%; P = 0.012), and surgery (56.3%; P = 0.028) all experienced a decrease in transfer rates during the time period studied. When gender was considered, males exhibited an increased rate of transfers to psychiatric facilities (P = 0.018).\nConclusion: \nSignificant reductions in both ED volume and transfers have coincided with the emergence of the COVID-19 pandemic. Further research is needed to determine how the current pandemic has affected patient care.","language":"English","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Emergency Medicine"},{"word":"COVID-19"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/620099vp","frozenauthors":[{"first_name":"Stephen","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Rocky Vista University College of Osteopathic Medicine, Parker, Colorado","department":"None"},{"first_name":"Anthony","middle_name":"J.","last_name":"Santarelli","name_suffix":"","institution":"Kingman Regional Medical Center, Departments of Graduate Medical Education, Kingman, Arizona","department":"None"},{"first_name":"Heesun","middle_name":"","last_name":"Choi","name_suffix":"","institution":"Kingman Regional Medical Center Emergency Medicine, Kingman, Arizona","department":"None"},{"first_name":"John","middle_name":"","last_name":"Ashurst","name_suffix":"","institution":"Kingman Regional Medical Center Emergency Medicine, Kingman, Arizona","department":"None"}],"date_submitted":"2020-11-18T21:24:34Z","date_accepted":"2020-11-18T21:24:34Z","date_published":"2021-05-17T19:58:24Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/14756/galley/7508/download/"}]}