Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic | Emergency Medicine | JAMA | JAMA Network
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Rosenbaum  L.  The untold toll—the pandemic’s effects on patients without Covid-19.   N Engl J Med. Published online April 17, 2020. doi:10.1056/NEJMms2009984PubMedGoogle Scholar
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    Research Letter
    June 5, 2020

    Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic

    Author Affiliations
    • 1Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai, New York, New York
    • 2Department of Population Health, New York University School of Medicine, New York
    JAMA. 2020;324(1):96-99. doi:10.1001/jama.2020.9972

    Anecdotal reports suggest hospitalizations, including for emergency conditions and elective procedures, have declined during the coronavirus disease 2019 (COVID-19) pandemic.1 Reduced hospitalizations for conditions requiring timely treatment may have significant public health consequences.

    The Department of Veterans Affairs (VA) is the largest health system in the US. The VA has ensured continuously available treatment for emergency conditions and canceled elective procedures during the COVID-19 pandemic.2 This study evaluated changes in the number of admissions to VA hospitals overall and for 6 common emergency conditions during the pandemic.

    We analyzed data from the VA’s Corporate Data Warehouse, a national repository of electronic health records from visits to any VA facility.3 We describe trends in VA hospitalizations overall, for 6 common emergency conditions, and for COVID-19 during the first 16 weeks of 2019 and 2020 among a previously established cohort of adults enrolled in VA care between 2008 and 2018. We compared the number and demographic characteristics of patients hospitalized during weeks 5 to 10 (January 29 to March 10) and weeks 11 to 16 (March 11 to April 21) of 2020 overall, among demographic subgroups, and by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) principal diagnosis codes I60-I69 for stroke, I21-I22 for myocardial infarction, I50 for heart failure, J44 for chronic obstructive pulmonary disease (COPD), K35-K37 for appendicitis, and J10-J18 for pneumonia. Incidence rate ratios (IRRs) comparing daily hospitalization counts during weeks 11 to 16 of 2020 vs January 1, 2019, through week 10 of 2020 were estimated using Poisson regressions that adjusted for seasonal variation and secular trends with week-of-year and year fixed effects.