Health Affairs (Millwood)
John D. Birkmeyer, Amber Barnato, Nancy Birkmeyer, Robert Kessler, Jonathan Skinner
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.