The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States

TLDR

US hospital admissions fell sharply at the onset of COVID‑19, but the extent of the rebound and differences across patient groups were poorly understood. The study seeks to guide health leaders in ensuring that patients with acute medical illnesses receive timely hospital care during the pandemic to prevent adverse outcomes. Non‑COVID admissions dropped more than 20% across all demographic subgroups, rebounded to 16% below baseline by mid‑2020, yet remained substantially lower for patients from majority‑Hispanic neighborhoods and for conditions such as pneumonia, COPD/asthma, sepsis, UTI, and STEMI.

Abstract

Hospital admissions in the US fell dramatically with the onset of the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about differences in admissions patterns among patient groups or the extent of the rebound. In this study of approximately one million medical admissions from a large, nationally representative hospitalist group, we found that declines in non-COVID-19 admissions from February to April 2020 were generally similar across patient demographic subgroups and exceeded 20 percent for all primary admission diagnoses. By late June/early July 2020, overall non-COVID-19 admissions had rebounded to 16 percent below prepandemic baseline volume (8 percent including COVID-19 admissions). Non-COVID-19 admissions were substantially lower for patients residing in majority-Hispanic neighborhoods (32 percent below baseline) and remained well below baseline for patients with pneumonia (-44 percent), chronic obstructive pulmonary disease/asthma (-40 percent), sepsis (-25 percent), urinary tract infection (-24 percent), and acute ST-elevation myocardial infarction (-22 percent). Health system leaders and public health authorities should focus on efforts to ensure that patients with acute medical illnesses can obtain hospital care as needed during the pandemic to avoid adverse outcomes.