Table 2.
Patient Acuity Measures and Surrogates of These During COVID Period Compared With Baseline in Academic Centers, Community Hospitals, and in Aggregatea
| Peri-COVID (2/9-3/16/20) vs COVID Period (3/17-4/21/20) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|
| Academic Hospitals |
Community Hospitals |
Overall |
|||||||
| 2/9/20-3/16/20 (N=16,181) | 3/17/20-4/21/20 (N=7779) | P | 2/9/20-3/16/20 (N=21,489) | 3/17/20-4/21/20 (N=10,867) | P | 2/9/20-3/16/20 (N=37,670) | 3/17/20-4/21/20 (N=18,646) | P | |
| ESI, no. (%) | |||||||||
| Level 1 | 133 (0.8) | 67 (0.9) | .94 | 163 (0.8) | 108 (1.0) | .078 | 296 (0.8) | 175 (0.9) | .14 |
| Level 2 | 3262 (20.2) | 1615 (20.8) | .43 | 3244 (15.1) | 1583 (14.6) | .34 | 6506 (17.3) | 3198 (17.2) | .90 |
| Level 3 | 9825 (60.7) | 4727 (60.8) | >.99 | 11,586 (53.9) | 6202 (57.1) | <.001b | 21,411 (56.9) | 10,929 (58.6) | <.001b |
| Level 4 | 2824 (17.5) | 1300 (16.7) | .28 | 5646 (26.3) | 2536 (23.53) | <.001b | 8470 (22.5) | 3836 (20.6) | <.001b |
| Level 5 | 81 (0.5) | 39 (0.5) | >.99 | 687 (3.2) | 368 (3.4) | .54 | 768 (2.0) | 407 (2.2) | .42 |
| ED length of stay (h), median (interquartile range) | 3.8 (2.5-.4) | 3.2 (2.0-4.5) | <.001b | 2.4 (1.4-3.7) | 2.2 (1.3-3.4) | .001b | 2.9 (1.8-4.5) | 2.6 (1.5-3.9) | <.001b |
| Trauma activation level | |||||||||
| None | 16,110 (99.6) | 7745 (99.6) | >.99 | 21,368 (99.4) | 10,789 (99.3) | .21 | 37,487 (99.5) | 18,534 (99.5) | .30 |
| Green | 9 (0.1) | 7 (0.1) | .65 | 14 (0.1) | 12 (0.1) | .39 | 23 (0.1) | 19 (0.1) | .24 |
| Yellow | 22 (0.1) | 11 (0.1) | >.99 | 75 (0.3) | 47 (0.4) | .43 | 97 (0.3) | 58 (0.3) | .43 |
| Red | 40 (0.2) | 16 (0.2) | .81 | 32 (0.1) | 19 (0.2) | .85 | 72 (0.2) | 35 (0.2) | >.99 |
| ED disposition, no. (%) | |||||||||
| Catheterization laboratory | 27 (0.2) | 4 (0.1) | .078 | 17 (0.1) | 9 (0.1) | >.99 | 44 (0.1) | 13 (0.1) | .24 |
| Discharge | 10,508 (65.0) | 4988 (64.1) | .35 | 16,968 (79.0) | 8535 (78.6) | .55 | 27,476 (72.9) | 13,523 (72.5) | .47 |
| Hospital admission | 3538 (21.8) | 1879 (24.2) | <.001b | 1531 (7.1) | 910 (8.4) | <.001b | 5069 (13.5) | 2789 (15.0) | <.001b |
| Hospital/ED observation | 1476 (9.1) | 742 (9.5) | .46 | 1262 (5.9) | 629 (5.8) | .89 | 2738 (7.3) | 1371 (7.4) | .87 |
| Irregular departure | 399 (2.5) | 77 (1.0) | <.001b | 327 (1.5) | 108 (1.0) | .002b | 726 (1.9) | 185 (1.0) | .001b |
| Operating room | 91 (0.6) | 44 (0.6) | >.99 | 101 (0.5) | 72 (0.7) | .076 | 192 (0.5) | 116 (0.6) | .20 |
| Transfer to health care facility | 117 (0.7) | 32 (0.4) | .016b | 1240 (5.8) | 579 (5.3) | .21 | 1357 (3.6) | 611 (3.3) | .11 |
| Other | 25 (0.2) | 13 (0.2) | >.99 | 43 (0.2) | 25 (0.2) | .81 | 55 (0.1) | 44 (0.2) | .048 |
| Pre-COVID (3/17-4/21/19) vs COVID Period (3/17-4/21/20) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|
| Academic Hospitals |
Community Hospitals |
Overall |
|||||||
| 2019 (N=15,139) | 2020 (N=7779) | P | 2019 (N=19,898) | 2020 (N=10,867) | P | 2019 (N=35,037) | 2020 (N=18,646) | P | |
| ESI, no. (%) | |||||||||
| Level 1 | 129 (0.9) | 67 (0.9) | >.99 | 134 (0.7) | 108 (1.0) | .010b | 263 (0.8) | 175 (0.9) | .049b |
| Level 2 | 3121 (20.6) | 1615 (20.8) | .97 | 2885 (14.5) | 1583 (14.6) | .99 | 6006 (17.1) | 3198 (17.2) | >.99 |
| Level 3 | 9032 (59.7) | 4727 (60.8) | .21 | 11,037 (55.5) | 6202 (57.1) | .021b | 20,069 (57.3) | 10,929 (58.6) | .007b |
| Level 4 | 2721 (18.0) | 1300 (16.7) | .024b | 4891 (24.6) | 2536 (23.4) | .021b | 7612 (21.7) | 3836 (20.6) | .007b |
| Level 5 | 84 (0.6) | 39 (0.5) | .85 | 758 (3.8) | 368 (3.4) | .13 | 842 (2.4) | 407 (2.2) | .21 |
| ED length of stay (h), median (interquartile range) | 3.6 (2.4-5.1) | 3.2 (2.0-4.5) | <.001b | 2.3 (1.4-3.6) | 2.2 (1.3-3.4) | .001b | 2.9 (1.7-4.3) | 2.6 (1.5-3.9) | <.001b |
| Trauma activation level, no. (%) | |||||||||
| None | 15,066 (99.5) | 7745 (99.6) | .88 | 19,777 (99.4) | 10,789 (99.3) | .43 | 34,843 (99.4) | 18,534 (99.4) | .70 |
| Green | 11 (0.1) | 7 (0.1) | .96 | 23 (0.1) | 12 (0.1) | >.99 | 34 (0.1) | 19 (0.1) | >.99 |
| Yellow | 21 (0.1) | 11 (0.1) | >.99 | 72 (0.4) | 47 (0.4) | .55 | 93 (0.3) | 58 (0.3) | .55 |
| Red | 41 (0.3) | 16 (0.2) | .58 | 26 (0.1) | 19 (0.2) | .58 | 67 (0.2) | 35 (0.2) | >.99 |
| ED disposition, no. (%) | |||||||||
| Catheterization laboratory | 24 (0.2) | 4 (0.1) | .10 | 11 (0.1) | 9 (0.1) | .66 | 35 (0.1) | 13 (0.1) | .48 |
| Discharge | 10,011 (66.1) | 4988 (64.1) | .007b | 15,562 (78.2) | 8535 (78.5) | .67 | 25,573 (73.0) | 13,523 (72.5) | .39 |
| Hospital admission | 3361 (22.2) | 1879 (24.2) | <.001b | 1613 (8.1) | 910 (8.4) | .56 | 4974 (14.2) | 2789 (15.0) | .024b |
| Hospital/ED observation | 1308 (8.6) | 742 (9.5) | .054b | 1222 (6.1) | 629 (5.8) | .35 | 2530 (7.2) | 1371 (7.4) | .76 |
| Irregular departure | 234 (1.5) | 77 (1.0) | .001b | 282 (1.4) | 108 (1.0) | .007b | 516 (1.5) | 185 (1.0) | .001b |
| Operating room | 89 (0.6) | 44 (0.6) | >.99 | 96 (0.5) | 72 (0.7) | .11 | 185 (0.5) | 116 (0.6) | .30 |
| Transfer to health care facility | 89 (0.6) | 32 (0.4) | .19 | 1069 (5.4) | 579 (5.3) | .99 | 1158 (3.3) | 611 (3.3) | .99 |
| Other | 23 (0.2) | 13 (0.2) | >.99 | 43 (0.2) | 25 (0.2) | >.99 | 66 (0.2) | 44 (0.2) | .43 |
a
COVID = coronavirus disease; ED = emergency department; ESI = emergency severity index.
b
Statistically significant.