Elsevier

Public Health

Volume 189, December 2020, Pages 6-11
Public Health

Original Research
Hospital admission rates, length of stay, and in-hospital mortality for common acute care conditions in COVID-19 vs. pre-COVID-19 era

https://doi.org/10.1016/j.puhe.2020.09.010Get rights and content

Highlights

  • Change in rate and types of admissions to acute care hospitals during the COVID-19 era is unknown.

  • We observed a sharp decline in overall admission volumes and in seven of eight common diagnostic categories.

  • We observed a concomitant increase in respiratory infections when comparing COVID-19 vs. pre-COVID-19 timeframe.

  • A statistically non-significant decrease in in-hospital mortality was observed.

Abstract

Objectives

The impact of COVID-19 upon acute care admission rates and patterns are unknown. We sought to determine the change in rates and types of admissions to tertiary and specialty care hospitals in the COVID-19 era compared with pre-COVID-19 era.

Methods

Acute care admissions to the largest tertiary care referral hospital, designated national referral centers for cardiac, cancer and maternity hospital in the State of Qatar during March 2020 (COVID-19 era) and January 2020 and March 2019 (pre-COVID-19 era) were compared. We calculated total admissions, admissions for eight specific acute care conditions, in-hospital mortality rate, and length of stay at each hospital.

Results

A total of 18,889 hospital admissions were recorded. A sharp decline ranging from 9% to 75% was observed in overall admissions. A decline in both elective and non-elective surgeries was observed. A decline of 9%–58% was observed in admissions for acute appendicitis, acute coronary syndrome, stroke, bone fractures, cancer, and live births, whereas an increase in admissions due to respiratory tract infections was observed. Overall length of stay was shorter in the COVID-19 period possibly suggesting lesser overall disease severity, with no significant change in in-hospital mortality. Unadjusted mortality rate for Qatar showed marginal increase in the COVID-19 period.

Conclusions

We observed a sharp decline in acute care hospital admissions, with a significant decline in admissions due to seven out of eight acute care conditions. This decline was associated with a shorter length of stay but not associated with a change in in-hospital mortality rate.

Keywords

COVID-19
Hospitalization
Hospital admissions
Utilization
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