Affiliation:
1. Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA
2. Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
3. 40th Forward Surgical Resuscitation Detachment, Fort Carson, CO 80913, USA
4. US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX 78234, USA
Abstract
ABSTRACT
Introduction
The coronavirus-2019 (COVID-19) pandemic has significantly impacted global healthcare delivery. Brooke Army Medical Center (BAMC) is the DoD’s largest hospital and a critical platform for maintaining a ready medical force. We compare temporal trends in patient volumes and characteristics in the BAMC emergency department (ED) before versus during the pandemic.
Materials and Methods
We abstracted data on patient visits from the BAMC ED electronic medical record system. Data included patient demographics, visit dates, emergency severity index triage level, and disposition. We visually compared the data from January 1, 2019 to November 30, 2019 versus January 1, 2020 to November 30, 2020 to assess the period with the most apparent differences. We then used descriptive statistics to characterize the pre-pandemic control period (1 March-November 30, 2019) versus the pandemic period (1 March-November 30, 2020).
Results
Overall, when comparing the pre-pandemic and pandemic periods, the median number of visits per day was 232 (Interquartile Range (IQR) 214-250, range 145-293) versus 165 (144-193, range 89-308, P < .0001). Specific to pediatric visits, we found the median number of visits per day was 39 (IQR 33-46, range 15-72) versus 18 (IQR 14-22, range 5-61, P < .001). When comparing the median number of visits by month, the volumes were lower during the pandemic for all months, all of which were strongly significant (P < .001 for all).
Conclusions
The BAMC ED experienced a significant decrease in patient volume during the COVID-19 pandemic starting in March 2020. This may have significant implications for the capacity of this facility to maintain a medically ready force.
Publisher
Oxford University Press (OUP)
Subject
Public Health, Environmental and Occupational Health,General Medicine
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