Impact of COVID-19 on Chronic Ambulatory-Care-Sensitive Condition Emergency Department Use Among Older Adults

Arch G Mainous 3rd; Lu Yin; James F Medley; Aaron A Saguil; Frank A Orlando

doi:10.3122/jabfm.2023.230386R1

Impact of COVID-19 on Chronic Ambulatory-Care-Sensitive Condition Emergency Department Use Among Older Adults

J Am Board Fam Med. 2024 Oct 25;37(4):792-795. doi: 10.3122/jabfm.2023.230386R1.

Authors

Arch G Mainous 3rd¹, Lu Yin², James F Medley², Aaron A Saguil², Frank A Orlando²

Affiliations

¹ From the Department of Community Health and Family Medicine, University of Florida, Gainesville, FL (AGM, LY, JFM, AAS, FAO), Department of Health Services Research Management, and Policy, University of Florida, Gainesville, FL (AGM). arch.mainous@ufl.edu).
² From the Department of Community Health and Family Medicine, University of Florida, Gainesville, FL (AGM, LY, JFM, AAS, FAO), Department of Health Services Research Management, and Policy, University of Florida, Gainesville, FL (AGM).

PMID: 39214696
DOI: 10.3122/jabfm.2023.230386R1

Abstract

Background: The COVID-19 pandemic social distancing requirements encouraged patients to avoid public spaces including in-office health care visits. Ambulatory-care-sensitive conditions (ACSCs) represent conditions that can be managed with quality primary care and when access is limited, these conditions can lead to avoidable emergency department (ED) visits.

Methods: Using national data on ED visits from 2019 to 2021 in the National Hospital Ambulatory Care Survey, we examined the impact of COVID-19 pandemic on ACSC ED visits among older adults (aged ≥65).

Results: The proportion of ED visits among older adults that were for ACSCs increased between 2019 (17.4%) and 2021 (18.5%). The trend in both rural (26.4%-28.6%) and urban areas (15.4%-16.8%) shows a significant jump from 2019 to 2021 (P < .001).

Conclusions: This rise in ACSC ED use is consistent with a delay in normal primary care during the pandemic.

Keywords: Access to Care; Ambulatory Care Sensitive Conditions; COVID-19; Emergency Departments; Pandemics; Primary Health Care.

MeSH terms

Aged
Aged, 80 and over
Ambulatory Care* / statistics & numerical data
COVID-19* / epidemiology
Chronic Disease / epidemiology
Emergency Service, Hospital* / statistics & numerical data
Female
Health Care Surveys
Health Services Accessibility / statistics & numerical data
Humans
Male
Pandemics
Primary Health Care* / statistics & numerical data
SARS-CoV-2
United States / epidemiology