TY - JOUR
T1 - The Impact of the COVID-19 Pandemic on Psychiatric Emergency Service Volume and Hospital Admissions
AU - Simpson, Scott A.
AU - Loh, Ryan M.
AU - Cabrera, Maximilliam
AU - Cahn, Megan
AU - Gross, Anne
AU - Hadley, Allison
AU - Lawrence, Ryan E.
N1 - Publisher Copyright:
© 2021 Academy of Consultation-Liaison Psychiatry
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Background: During the COVID-19 pandemic, there have been an increasing number of emergency department visits for behavioral health reasons, even as overall emergency department volumes have decreased. The impact of the pandemic and related public health interventions on specialized psychiatric emergency services has not been described. These services provide high-intensity care for severely ill patients who are likely to be homeless and underserved. Objective: We describe the change in total volume and psychiatric hospitalization rates among three psychiatric emergency services across the United States. Methods: Changes in volumes and hospitalization were assessed for statistical significance using a seasonal autoregressive integrated moving average with exogenous factors model from January 2018 to December 2020. Results: The pandemic's impact on volumes and hospitalization varied by site. In Denver (CO), there was a statistically significant 9% decrease in overall volumes, although an 18% increase in hospitalizations was not significant. In New York City (NY), there was a significant 7% decrease in volumes as well as a significant 6% decrease in hospitalizations. In Portland (OR), volumes decreased by 4% and hospitalizations increased by 6% although differences did not reach statistical significance. Conclusions: There has been a decrease in volume at these services after the pandemic, but there are substantial variations in the magnitude of change and demand for hospitalization by region. These findings suggest a need to understand where patients in crisis are seeking care and how systems of care must adapt to changing utilization in the pandemic era.
AB - Background: During the COVID-19 pandemic, there have been an increasing number of emergency department visits for behavioral health reasons, even as overall emergency department volumes have decreased. The impact of the pandemic and related public health interventions on specialized psychiatric emergency services has not been described. These services provide high-intensity care for severely ill patients who are likely to be homeless and underserved. Objective: We describe the change in total volume and psychiatric hospitalization rates among three psychiatric emergency services across the United States. Methods: Changes in volumes and hospitalization were assessed for statistical significance using a seasonal autoregressive integrated moving average with exogenous factors model from January 2018 to December 2020. Results: The pandemic's impact on volumes and hospitalization varied by site. In Denver (CO), there was a statistically significant 9% decrease in overall volumes, although an 18% increase in hospitalizations was not significant. In New York City (NY), there was a significant 7% decrease in volumes as well as a significant 6% decrease in hospitalizations. In Portland (OR), volumes decreased by 4% and hospitalizations increased by 6% although differences did not reach statistical significance. Conclusions: There has been a decrease in volume at these services after the pandemic, but there are substantial variations in the magnitude of change and demand for hospitalization by region. These findings suggest a need to understand where patients in crisis are seeking care and how systems of care must adapt to changing utilization in the pandemic era.
KW - COVID-19
KW - community mental health
KW - emergency psychiatry
KW - health services
KW - psychiatric emergency services
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U2 - 10.1016/j.jaclp.2021.05.005
DO - 10.1016/j.jaclp.2021.05.005
M3 - Article
C2 - 34058432
AN - SCOPUS:85107952663
SN - 2667-2979
VL - 62
SP - 588
EP - 594
JO - Journal of the Academy of Consultation-Liaison Psychiatry
JF - Journal of the Academy of Consultation-Liaison Psychiatry
IS - 6
ER -