Trends in ED Visits and Hospital Deaths During COVID-19: An Analysis of CDC and Telehealth Data

Trends in Emergency Department Visits and Hospital Deaths During the COVID-19 Pandemic:

A Comparative Analysis of CDC and Telehealth Call Center Data

Authors:

David A. Thompson 1

Jeanine Feirer

1 Northwestern University, Northwestern University Feinberg School of Medicine

Introduction: The COVID-19 pandemic significantly impacted healthcare systems worldwide, leading to fluctuations in emergency department (ED) visits and hospital deaths. During this same period, medical call centers and offices encountered a surge of COVID-19-related telehealth triage calls. This study aimed to investigate the correlation between the frequency of telehealth triage encounters and the number of COVID-19-related Emergency Department (ED) visits and hospital deaths, as reported by the Centers for Disease Control and Prevention (CDC).

Methods: Data for years 2020 through 2022 was obtained from the CDC’s COVID-19 Tracker, which monitors ED visits and hospital deaths attributed to COVID-19. Encounter data (N = 1,026,920) from two large North American medical call center software companies was analyzed for the percent of telehealth encounters where either the adult COVID-19 Exposure or COVID-19 Diagnosed or Suspected guidelines were used during triage. The call center data represents telephone encounters between patients seeking medical advice and telehealth triage nurses. The data from both sources was graphically analyzed and compared by calendar week for the three-year period.

Results: Fluctuations in ED visits and hospital deaths observed in the CDC data were closely mirrored by the patterns observed in the call center data.

Discussion: The telehealth call center data provides valuable insights into the patients seeking medical advice remotely, potentially mitigating the burden on already overwhelmed EDs and hospitals. These findings underscore the importance of telehealth services in supporting healthcare systems during public health emergencies. The similar trending of the CDC data and telehealth call center data suggests that telehealth services could serve an important role in syndromic surveillance during a pandemic. This is especially important because the telehealth encounter data includes those patients who manage their symptoms at home and do not seek medical care. These patients are often not captured with traditional surveillance data (e.g., ED visits, hospital deaths, hospitalizations). There were some small differences between the two data sets pertaining to when various peaks in COVID-19 occurred. These differences could be explained by regional differences in the spread of COVID-19 during the pandemic. This study highlights the potential of telehealth encounters as an additional layer of syndromic surveillance, reinforcing the need for integrated healthcare data networks in our evolving healthcare landscape.

Conclusion: There were parallel trends between ED visits, hospital deaths and telehealth call center encounters during the COVID-19 pandemic.

Attribution: The authors are grateful to Keona Health (www.keonahealth.com) and a second company (requested to participate anonymously) for providing the data used in this article. These two companies provide telehealth triage clinical decision support software and services, which license Schmitt-Thompson Telehealth Triage Guidelines (www.stcc-triage.com).

Citation: Thompson DA, Feirer J. Trends in Emergency Department Visits and Hospital Deaths During the COVID-19 Pandemic: A Comparative Analysis of CDC and Telehealth Call Center Data. September 15, 2023.

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